A new study has shed light on the optimal treatment for high blood pressure in patients taking ibrutinib or related drugs.
The type of treatment may depend on whether the hypertension is pre-existing or new onset, according to the first study of its kind, reported in Blood Advances.
The team of US researchers was led by Dr Mazyar Shadman from The Fred Hutchinson Cancer Center in Seattle, USA. They say their research is the first to examine the best treatment for hypertension faced by people being treated for a range of blood cancers with BTK-inhibitors (BTKi) such as ibrutinib.
As many as 78% of patients have increased blood pressure following treatment with ibrutinib, according to a previous study.
The new retrospective study looked at the medical records of 196 patients, with 78 of these beginning anti-hypertensive treatment after starting ibrutinib or other BTKi treatments, and 118 receiving anti-hypertension treatment prior to ibrutinib.
The analysis suggested that those with new onset hypertension gained most benefit from ACE inhibitors or angiotensin receptor blockers along with hydrochlorothiazide. Those with existing hypertension seemed to benefit most from a combination of beta-blockers and hydrochlorothiazide.
First author of the study, Dr Laura Samples from the Fred Hutch, said: “Our results reinforce that – in this patient population as in patients with hypertension in general – you need to treat with multiple drugs to achieve successful blood pressure control.
“Large prospective studies are needed to develop formal guidelines on the most effective antihypertensive regimens in patients taking BTKis.”
Samples L, Voutsinas JM MPH, Fakhri B, Khajavian S, Spurgeon SE, Stephens DM, Skarbnik AP, Mato AR, Broome C, Gopal AK, Smith SD, Lynch RC, Rainey MA, Kim MS, Barrett-Campbell O, Hemond E, Tsang M, Ermann DA, Malakhov N, Rao D, Shakib-Azar M, Morrigan B, Chauhan A, Plate T, Gooley TA, Ryan K, Lansigan F, Hill BT, Pongas G, Parikh SA, Roeker LE, Allan JN, Cheng R, Ujjani C, Shadman M. (2024) “Hypertension Treatment in Patients Receiving Ibrutinib: A Multicenter Retrospective Study.” Blood Advances, doi: 10.1182/bloodadvances.2023011569
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