5PSQ-040 Security profile of ibrutinib as monotherapy in patients with chronic lymphocytic leukaemia: experience in a tertiary hospital

• Published in: European journal of hospital pharmacy. Science and practice Vol. 27; no. Suppl 1; p. A168
• Main Authors: Fernandez Cuerva, C, Ortega De La Cruz, C, Ortiz, M, Muñoz Castillo, MI
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01-03-2020
• Subjects: Computerized physician order entry; Cytogenetics; Leukemia; Neutropenia; Targeted cancer therapy
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2020-eahpconf.357

Background and importanceIbrutinib is a tyrosine kinase inhibitor indicated for the treatment of chronic lymphocytic leukaemia (CLL) among other pathologies.Aim and objectivesTo assess the frequency and severity of adverse events (AEs) in CLL patients treated with ibrutinib.Material and methodsThis was an observational, retrospective, descriptive study including all patients aged >18 years old diagnosed with LLC treated with ibrutinib 420 mg/24 hours in our hospital. The study period was July 2015–September 2019. Variables collected were sex, age, diagnosis and cytogenetics, previous treatment lines, duration of treatment, AEs, dose adjustment, temporal discontinuations and definitive suspensions. AEs were classified following the National Institute Cancer (NCI): Common Terminology Criteria for Adverse Events (CTCAE) V.5.0. Data were collected from the electronic clinical history, electronic prescribing software and drug therapy follow-up.ResultsThirty-one patients were included (9 women and 22 men) with an average age of 72 years (range 48–90). Poor prognostic cytogenetics was presented in 71% of patients: 45.16% had del (17p), 12.90% had del (11q) and 12.90% had both. Ibrutinib was prescribed as firstline treatment in 10 patients and as rescue treatment in 21 patients that had a median of 1 previous line (range 1–5).Median length of treatment was 12.7 months (range 2–42.3). Nine patients suspended ibrutinib permanently: progression (n=5), death (n=2), grade 3/4 AEs (n=1, haemorrhagic) and alogenic transplant (n=1). In addition, six patients discontinued ibrutinib because of grade 3/4 neutropenia (n=3), respiratory infections (n=2) and bleeding grade 3/4 (n=1). Twenty-two patients were continuing ibrutinib treatment when the study was closed.AEs grade 1/2 included musculoskeletal AEs (muscle cramps (n=3), arthralgia (n=4), musculoskeletal pain (n=3)), haematologic AEs (neutropenia (n=1), thrombocytopenia (n=1)), gastrointestinal AEs (diarrhoea (n=1)) and infections (urinary (n=1), periferic oedema (n=1)). One patient was diagnosed with atrial fibrillation and another with hypertension that required treatment.Conclusion and relevanceIn our patients, ibrutinib had an adequate safety profile, highlighting haemorrhage as the most serious AE. Periodic follow-up of patients is necessary to assess adverse reactions and the need for temporary suspension in patients.References and/or acknowledgementsNo conflict of interest.