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January 7, 2026Blood AdvancesOpen Access

Real-world safety and effectiveness of zanubrutinib vs ibrutinib in CLL: the CLL-ZANU2024 Italian cohort

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Authors

EMEnrica Antonia MartinoAPAnnalisa PitinoEVErnesto Vigna

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Overview

Multicenter retrospective study reveals superior persistence and disease control with zanubrutinib over ibrutinib in chronic lymphocytic leukemia, indicating enhanced real-world tolerability.

Key Points

  • To compare the real-world safety, persistence, and effectiveness of zanubrutinib versus ibrutinib in patients with chronic lymphocytic leukemia treated outside clinical trials.
  • Multicenter retrospective cohort study of 934 patients with chronic lymphocytic leukemia treated in Italian centers, with 393 receiving zanubrutinib and 541 receiving ibrutinib.
  • Evaluated time to treatment discontinuation (TTD) and time to next treatment or death (TTNTD) in the overall cohort and in a propensity score-matched population using multivariable models.
  • Zanubrutinib significantly reduced 12-month treatment discontinuation rates compared to ibrutinib in both the overall cohort (12.6% vs 21.4%) and the propensity score-matched cohort (12.4% vs 20.2%).
  • 12-month rates of time to next treatment or death were higher with zanubrutinib than ibrutinib in the overall cohort (91.9% vs 83.0%) and matched cohort (93.2% vs 83.4%).
  • Adverse events prompting discontinuation, notably atrial fibrillation, bleeding events, and infections, occurred less frequently in patients treated with zanubrutinib.

Cite This Study

Martino et al. (2026) studied this question.

synapsesocial.com/papers/6a811ba2046b5fb0cc6483bbhttps://doi.org/10.1182/bloodadvances.2025018757
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Real world outcomes of zanubrutinib monotherapy for CLL/SLL focusing on treatment discontinuation and BTKi switching: A single center retrospective analysis2025
  2. 2Adverse event profiles of acalabrutinib and zanubrutinib in chronic lymphocytic leukemia: A real-world comparison2025 · 1 citations
  3. 3Real‐World Treatment Patterns and Outcomes of Zanubrutinib in Chronic Lymphocytic Leukemia and Small Lymphocytic Leukemia (<scp>CLL</scp>/<scp>SLL</scp>)2025 · 2 citations
  4. 4Cardiotoxicity and safety of zanubrutinib versus chemoimmunotherapy in chronic lymphocytic leukemia: a real-world retrospective cohort study using the TriNetX registry2026
  5. 5A Comprehensive Review of the Role of Zanubrutinib for Patients with Chronic Lymphocytic Leukemia2026