Key result
Zanubrutinib is associated with an absolute ~11-point lower AF incidence than historical ibrutinib.
Why the study?
AF complicates Bruton tyrosine kinase inhibitor therapy in chronic lymphocytic leukemia, motivating an evaluation of AF incidence during zanubrutinib treatment compared with historical ibrutinib controls.
Does zanubrutinib reduce the incidence of treatment-emergent atrial fibrillation compared to a historical ibrutinib control in patients with chronic lymphocytic leukemia?
Cohort (n=1,033)
Yes
Does zanubrutinib reduce the incidence of treatment-emergent atrial fibrillation compared to a historical ibrutinib control in patients with chronic lymphocytic leukemia?
In a large real-world multicenter cohort of patients with chronic lymphocytic leukemia, treatment with the second-generation BTK inhibitor zanubrutinib was associated with a low incidence of atrial fibrillation (1.33% over 15.5 months), even among patients in higher baseline cardiovascular risk strata.
Answers are grounded in this paper and cite their sources.
Zanubrutinib was associated with lower atrial fibrillation incidence versus historical ibrutinib in CLL; leaves open prospective validation before changing BTK inhibitor selection.
Introduction Atrial fibrillation (AF) complicates Bruton tyrosine kinase inhibitor therapy in chronic lymphocytic leukemia. Methods We retrospectively evaluated 679 zanubrutinib‐treated patients across 52 Italian centers, with 354 historical ibrutinib‐treated controls. Shanafelt AF scores were assessed. Results Nine zanubrutinib‐treated patients developed AF (1.33%) during median treatment of 15.5 months, versus 42 historical controls (11.9%) over median observation of 25 months. Five zanubrutinib events occurred among patients scoring ≥ 5. No affected patients experienced embolic or bleeding complications. Conclusion AF was uncommon during zanubrutinib treatment, even in the higher‐risk subgroup. Historical comparisons remain limited, and exploratory score findings require confirmation with longer follow‐up. Trial Registration The authors have confirmed clinical trial registration is not needed for this submission
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Visentin et al. (2026) conducted a cohort in Chronic lymphocytic leukemia (CLL) (n=1,033). Zanubrutinib vs. Historical ibrutinib-treated control was evaluated on New-onset atrial fibrillation (AF). Zanubrutinib treatment in chronic lymphocytic leukemia was associated with a 1.33% crude incidence of atrial fibrillation over 15.5 months compared to 11.9% in historical ibrutinib controls.
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