Pan Yilin, Zhao Yanan, Ren Hangyu, Wang Xintong, Liu Caixia, Du Beibei, Nanthakumar Kumaraswamy, Yang Ping
Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Cardiovascular Research Institute, Changchun, China.
Department of Critical Care Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Front Pharmacol. 2024 Nov 19;15:1513913. doi: 10.3389/fphar.2024.1513913. eCollection 2024.
The Bruton's Tyrosine Kinase Inhibitor, ibrutinib, has been widely employed due to its significant efficacy in B-cell lymphoma. However, the subsequent cardiac complications, notably atrial fibrillation (AF) and ventricular arrhythmias (VAs),associated with ibrutinib treatment have emerged as a major concern in cardio-oncology and hematology. Ibrutinib-induced AF has been well described, whereas mechanisms of ibrutinib-induced VAs are still under-investigation. The incidence of ibrutinib-induced VAs can vary vastly due to under-recognition and limitations of the retrospective studies. Recent investigations, including our previous work, have proposed several potential mechanisms contributing to this adverse event, necessitating further validation. The development of effective strategies for the prevention and treatment of ibrutinib-induced VAs still requires in-depth exploration. This review aims to establish a comprehensive framework encompassing the epidemiology, mechanistic insights, and clinical considerations related to ibrutinib-induced VAs. This article outlines potential strategies for the clinical management of patients undergoing ibrutinib therapy based on suggested mechanisms.
布鲁顿酪氨酸激酶抑制剂依鲁替尼因其在B细胞淋巴瘤中的显著疗效而被广泛应用。然而，随后与依鲁替尼治疗相关的心脏并发症，尤其是心房颤动（AF）和室性心律失常（VAs），已成为心脏肿瘤学和血液学中的一个主要问题。依鲁替尼诱发的AF已有详细描述，而依鲁替尼诱发VAs的机制仍在研究中。由于回顾性研究的认识不足和局限性，依鲁替尼诱发VAs的发生率差异很大。包括我们之前的工作在内的近期研究提出了几种导致这一不良事件的潜在机制，需要进一步验证。开发预防和治疗依鲁替尼诱发VAs的有效策略仍需要深入探索。本综述旨在建立一个全面的框架，涵盖与依鲁替尼诱发VAs相关的流行病学、机制见解和临床考虑因素。本文根据所提出的机制概述了接受依鲁替尼治疗患者的临床管理潜在策略。
