ArticleJournal of hematology & oncology2022
Hypertension and incident cardiovascular events after next-generation BTKi therapy initiation.
Article in Journal of hematology & oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Cardiovascular Challenges in Chronic Lymphocytic Leukemia (CLL) Patients Undergoing Bruton Tyrosine Kinase (BTK) Inhibitor Therapy.European journal of haematology · 2026Pooled it
- Pirtobrutinib monotherapy in Bruton tyrosine kinase inhibitor-intolerant patients with B-cell malignancies: results of the phase I/II BRUIN trial.Haematologica · 2025Trial
- Safety and Management of Targeted Therapies for Relapsed/Refractory Chronic Lymphocytic Leukemia.Drug safety · 2026Review
- Cardiovascular Toxicity of BTK Inhibitors: A Patient-Centered Framework for Risk Stratification and Management.Journal of clinical medicine · 2026Review
- Cardiovascular Toxicity of BTKi in Chronic B-Cell Malignancies.Reviews in cardiovascular medicine · 2026Review
- Additional Value of Cardiac Assessment With OncologicReviews in cardiovascular medicine · 2026Article
- Metabolomic Profiling of Tyrosine Kinase Inhibitor-Induced Endothelial Dysfunction and Cardiovascular Toxicity.Metabolites · 2026Review
- Cardiovascular Safety of Bruton Tyrosine Kinase Inhibitors: From Ibrutinib to Next-Generation Agents.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026Review
- Practical Management of Cardiovascular Adverse Events with BTKi Treatment in Patients with Chronic Lymphocytic Leukemia: A Consensus Report by Hematologists and Cardiologists.Acta haematologica · 2026Review
- Considerations for the practical management of cardiovascular risk with Bruton's tyrosine kinase inhibitors for patients with chronic lymphocytic leukemia.The oncologist · 2025Review
- Navigating the Complexities of Cancer Treatment-Induced Hypertension.Journal of cardiovascular development and disease · 2025Review
- Is lenvatinib-induced blood pressure elevation a favorable prognostic factor in patients with hepatocellular carcinoma?Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- A Comparative Analysis of Cardiovascular Events Associated With Acalabrutinib Versus Ibrutinib in Chronic Lymphocytic Leukemia: Insights From a Global Federated Network.Pharmacology research & perspectives · 2025Article
- Cardiotoxicity of small-molecule kinase inhibitors in cancer therapy.Experimental hematology & oncology · 2025Review
- BTK inhibitors and next-generation BTK-targeted therapeutics for B-cell malignancies.Archives of pharmacal research · 2025Review
- Reversible posterior leukoencephalopathy syndrome (RPLS) in a patient with chronic lymphocytic leukemia (CLL) treated with Acalabrutinib, a Bruton's tyrosine kinase (BTK) inhibitor: a case report.Acta neurologica Belgica · 2025Article
- Cardio-Oncology and Heart Failure: a Scientific Statement From the Heart Failure Society of America.Journal of cardiac failure · 2025Review
- Investigation of the mechanism of hypertension caused by BTKi in the treatment of hematologic diseases.Frontiers in pharmacology · 2025Review
- Safety of Extended Pirtobrutinib Exposure in Relapsed and/or Refractory B-Cell Malignancies.Acta haematologica · 2025Article
- Differential Cardiotoxicity of Ibrutinib Versus Chemoimmunotherapy in Chronic Lymphocytic Leukemia: A Population-Based Study.Journal of clinical medicine · 2024Article
Corrections and comments
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Authors and funding
18 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundPost-market analyses revealed unanticipated links between first-generation Bruton's tyrosine kinase inhibitor (BTKi) therapy, ibrutinib, and profound early hypertension. Yet, whether this is seen with novel selective second (next)-generation BTKi therapy, acalabrutinib, is unknown.
methodsLeveraging a large cohort of consecutive B cell cancer patients treated with acalabrutinib from 2014 to 2020, we assessed the incidence and ramifications of new or worsened hypertension [systolic blood pressure (SBP) ≥ 130 mmHg] after acalabrutinib initiation. Secondary endpoints were major cardiovascular events (MACE: arrhythmias, myocardial infarction, stroke, heart failure, cardiac death) and disease progression. Observed incident hypertension rates were compared to Framingham heart-predicted and ibrutinib-related rates. Multivariable regression and survival analysis were used to define factors associated with new/worsened hypertension and MACE, and the relationship between early SBP increase and MACE risk. Further, the effect of standard antihypertensive classes on the prevention of acalabrutinib-related hypertension was assessed.
resultsOverall, from 280 acalabrutinib-treated patients, 48.9% developed new/worsened hypertension over a median of 41 months. The cumulative incidence of new hypertension by 1 year was 53.9%, including 1.7% with high-grade (≥ 3) hypertension. Applying the JNC 8 cutoff BP of ≥ 140/90 mmHg, the observed new hypertension rate was 20.5% at 1 year, > eightfold higher than the Framingham-predicted rate of 2.4% (RR 8.5, P < 0.001), yet 34.1% lower than ibrutinib (12.9 observed-to-expected ratio, P < 0.001). In multivariable regression, prior arrhythmias and Black ancestry were associated with new hypertension (HR 1.63, HR 4.35, P < 0.05). The degree of SBP rise within 1 year of treatment initiation predicted MACE risk (42% HR increase for each + 5 mmHg SBP rise, P < 0.001). No single antihypertensive class prevented worsened acalabrutinib-related hypertension.
conclusionsCollectively, these data suggest that hypertension may be a class effect of BTKi therapies and precedes major cardiotoxic events.
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