PMID- 35973891
OWN - NLM
STAT- MEDLINE
DCOM- 20221026
LR  - 20221027
IS  - 2152-2669 (Electronic)
IS  - 2152-2669 (Linking)
VI  - 22
IP  - 11
DP  - 2022 Nov
TI  - Real-World Persistence and Time to Next Treatment With Ibrutinib in Patients With 
      Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma Including Patients at 
      High Risk for Atrial Fibrillation or Stroke.
PG  - e959-e971
LID - S2152-2650(22)00222-1 [pii]
LID - 10.1016/j.clml.2022.07.004 [doi]
AB  - BACKGROUND: Atrial fibrillation (AF) is a recognized adverse consequence 
      associated with all Bruton's tyrosine kinase inhibitors used to treat chronic 
      lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL); however, real-world 
      time to discontinuation (TTD) and time to next treatment (TTNT) of CLL/SLL 
      patients with a high baseline AF/stroke risk remain unknown. MATERIALS AND 
      METHODS: Patients with CLL/SLL from a nationwide electronic health record-derived 
      database (February 12, 2013-January 31, 2021) initiating first-line (1L) or 
      second or later-line (2L+) treatment with ibrutinib or other regimens on or after 
      February 12, 2014 (index date) were analyzed. Kaplan-Meier survival analysis was 
      used to assess TTD and TTNT among all patients, patients with high AF risk 
      (CHARGE-AF risk score >/=10.0%), and patients at high risk of stroke 
      (CHA(2)DS(2)-VASc risk score >/=3 [females] or >/=2 [males]). RESULTS: In 1L/2L+, 
      2190/1851 patients received ibrutinib and 4388/4135, were treated with other 
      regimens. Median TTD for ibrutinib was similar regardless of AF/stroke-related 
      risk (1L: all patients, 15.7 months; high AF risk, 11.7 months; high stroke risk, 
      13.7 months; similar results in 2L+). Median TTNT was significantly longer for 
      ibrutinib vs. other regimens (1L: not reached vs. 45.9 months; 2L+: not reached 
      vs. 23.6 months; both P < .05), including among those with high AF/stroke risk. 
      TTNT was similar between all patients and high-risk cohorts in 1L and 2L+ (all P 
      > .05). CONCLUSION: This study highlights that elevated baseline 
      AF/stroke-related risk does not adversely impact TTD and TTNT outcomes associated 
      with ibrutinib use. Additionally, TTNT was significantly longer for patients 
      treated with ibrutinib vs. other regimens.
CI  - Copyright (c) 2022 The Author(s). Published by Elsevier Inc. All rights reserved.
FAU - Narezkina, Anna
AU  - Narezkina A
AD  - University of California San Diego Health, San Diego, CA.
FAU - Akhter, Nausheen
AU  - Akhter N
AD  - Northwestern Medicine, Chicago, IL.
FAU - Lu, Xiaoxiao
AU  - Lu X
AD  - Janssen Scientific Affairs, LLC, Horsham, PA.
FAU - Emond, Bruno
AU  - Emond B
AD  - Analysis Group, Inc., Montreal, Quebec, Canada. Electronic address: 
      Bruno.Emond@analysisgroup.com.
FAU - Panjabi, Sumeet
AU  - Panjabi S
AD  - Janssen Scientific Affairs, LLC, Horsham, PA.
FAU - Forbes, Shaun P
AU  - Forbes SP
AD  - Analysis Group, Inc., Menlo Park, CA.
FAU - Hilts, Annalise
AU  - Hilts A
AD  - Analysis Group, Inc., Montreal, Quebec, Canada.
FAU - Liu, Stephanie
AU  - Liu S
AD  - Analysis Group, Inc., Menlo Park, CA.
FAU - Lafeuille, Marie-Helene
AU  - Lafeuille MH
AD  - Analysis Group, Inc., Montreal, Quebec, Canada.
FAU - Lefebvre, Patrick
AU  - Lefebvre P
AD  - Analysis Group, Inc., Montreal, Quebec, Canada.
FAU - Huang, Qing
AU  - Huang Q
AD  - Janssen Scientific Affairs, LLC, Horsham, PA.
FAU - Choi, Michael
AU  - Choi M
AD  - University of California San Diego Moores Cancer Center, San Diego, CA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220715
PL  - United States
TA  - Clin Lymphoma Myeloma Leuk
JT  - Clinical lymphoma, myeloma & leukemia
JID - 101525386
RN  - 1X70OSD4VX (ibrutinib)
RN  - 0 (Pyrimidines)
RN  - 0 (Pyrazoles)
RN  - 0 (Protein Kinase Inhibitors)
SB  - IM
MH  - Male
MH  - Female
MH  - Humans
MH  - *Leukemia, Lymphocytic, Chronic, B-Cell/complications/drug therapy
MH  - Pyrimidines/adverse effects
MH  - Pyrazoles/adverse effects
MH  - *Atrial Fibrillation/complications/chemically induced
MH  - *Lymphoma, B-Cell
MH  - Protein Kinase Inhibitors/adverse effects
MH  - *Stroke/etiology
OTO - NOTNLM
OT  - Bruton's tyrosine kinase inhibitor
OT  - CHA(2)DS(2)-VASc
OT  - CHARGE-AF
OT  - CLL/SLL
OT  - treatment discontinuation
COIS- Disclosure A.N. has received consulting fees from Pharmacyclics, Janssen 
      Scientific Affairs, and Epsilon imaging Inc. B.E., A.H., S.L., M-H.L., and P.L. 
      are employees of Analysis Group, Inc., which has provided paid consulting 
      services to Janssen Scientific Affairs, LLC. S.P.F. was an employee of Analysis 
      Group, Inc. at the time the study was conducted. S.P., X.L., and Q.H. are 
      employees of Janssen Scientific Affairs, LLC, and stockholders of Johnson & 
      Johnson. M.C. has received research funding from Abbvie, Pharmacyclics, 
      Oncternal, Velosbio, Merck, and Geron. N.A. reports no relevant conflicts of 
      interest related to this work.
EDAT- 2022/08/17 06:00
MHDA- 2022/10/27 06:00
CRDT- 2022/08/16 22:04
PHST- 2022/05/23 00:00 [received]
PHST- 2022/06/24 00:00 [revised]
PHST- 2022/07/08 00:00 [accepted]
PHST- 2022/08/17 06:00 [pubmed]
PHST- 2022/10/27 06:00 [medline]
PHST- 2022/08/16 22:04 [entrez]
AID - S2152-2650(22)00222-1 [pii]
AID - 10.1016/j.clml.2022.07.004 [doi]
PST - ppublish
SO  - Clin Lymphoma Myeloma Leuk. 2022 Nov;22(11):e959-e971. doi: 
      10.1016/j.clml.2022.07.004. Epub 2022 Jul 15.