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Ibrutinib Therapy Linked to New, Worsened Hypertension

Ibrutinib-related hypertension associated with increased risk for major adverse cardiovascular events

FRIDAY, Oct. 11, 2019 (HealthDay News) — Ibrutinib is associated with an increased risk for new or worsened hypertension in patients treated for B-cell malignancies, according to a study published online Oct. 3 in Blood.

Tyler Dickerson, Ph.D., from The Ohio State University in Columbus, and colleagues examined the incidence of new/incident or worsened hypertension among 562 patients treated with ibrutinib for B-cell malignancies. The association of hypertension following initiation of ibrutinib with the development of other major adverse cardiovascular events (MACE), including arrhythmias, myocardial infarction, stroke, heart failure, and cardiovascular death, was examined.

The researchers found that during a median of 30 months, 78.3 percent of ibrutinib users developed new or worsened hypertension (mean systolic blood pressure increase, 5.2 mm Hg). In 71.6 percent of ibrutinib users, new hypertension developed (467 observed versus 39 Framingham-heart predicted cases per 1,000 person-years); the time-to-50 percent cumulative incidence was 4.2 months. Overall, 17.7 percent of those without preceding hypertension developed high-grade hypertension (blood pressure greater than 160/100 mm Hg). New or worsened hypertension following initiation of ibrutinib was associated with increased MACE in a multivariable analysis including known predictors of MACE (hazard ratio, 2.17). Initiation of antihypertensive agents was associated with a reduced risk for MACE (hazard ratio, 0.40).

“Given the expected continued increase in ibrutinib use, further studies characterizing the mechanisms, treatment, and implications of hypertension during ibrutinib use are needed,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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