Antithrombotic prophylaxis in patients treated with Bruton’s tyrosine kinase inhibitors

There is an increased risk of atrial fibrillation in patients treated with Bruton’s tyrosine kinase inhibitors such as ibrutinib or acalabrutinib. The risk of this complication, as in the general population, increases with the age of patients and the coexistence of cardiovascular diseases. Due to the observed platelet dysfunction associated with the activity of ibrutinib, antithrombotic prophylaxis against stroke becomes an important clinical problem. The presence of potential interactions between ibrutinib and oral anticoagulant and additionally increased risk of bleeding determine specific therapeutic choices, which are described in the article.