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Infection Risk With BTK Inhibitors Low, New CLL Study Finds

A recent study on chronic lymphocytic leukemia (CLL) patients using Bruton’s tyrosine kinase (BTK) inhibitors shows a minimal increase in the risk of invasive fungal infections, with a 1% higher risk compared to those not using BTK inhibitors. The study, published in Open Forum Infectious Diseases, emphasizes the need for further research to identify high-risk patient groups and effective prevention interventions.

A new analysis of patients with chronic lymphocytic leukemia (CLL) indicates that the use of Bruton’s tyrosine kinase (BTK) inhibitors can slightly increase the risk of certain invasive fungal infections. The study, published in Open Forum Infectious Diseases, found that the incidence of invasive fungal infections at 5 years was 4.6% among those taking a BTK inhibitor, compared to 3.5% among those not taking a BTK inhibitor. Specifically, about 1% of patients with CLL developed an invasive fungal infection while on a BTK inhibitor during the study period.
The study utilized a global research database to identify CLL patients and conducted a case-control propensity score-matched analysis to correlate invasive fungal infections with BTK inhibitor use. Among the findings, the adjusted infection event analysis revealed an elevated rate of Pneumocystis jirovecii pneumonia (PJP) and invasive candidiasis among BTK inhibitor users. However, the authors noted that the number needed to harm for patients on a BTK inhibitor was relatively low, suggesting a minimal risk.
Despite these findings, the study acknowledges certain limitations, including potential misclassification of infections in patient records and the lack of precise data on BTK inhibitor dosage and exposure time. The authors conclude that their data do not support routine PJP prophylaxis in this patient population, considering the low risk observed. They advocate for further research to identify specific patient groups at higher risk and to explore effective prevention interventions.
References:
  1. Agudelo Higuita NI, Chastain DB, Scott B, et al. Risk of invasive fungal infections in patients with chronic lymphocytic leukemia treated with bruton tyrosine kinase inhibitors: a case-control propensity score-matched analysis. Open Forum Infect Dis. 2024;11(6):ofae115. doi:10.1093/ofid/ofae115
  2. Tham K, Prelewicz S, deHoll S, Stephens DM, Gomez CA. Infectious complications among patients receiving ibrutinib for the treatment of hematological malignancies. Am J Health Syst Pharm. 2024;81(4):112-119. doi:10.1093/ajhp/zxad210
  3. Tillman BF, Pauff JM, Satyanarayana G, Talbott M, Warner JL. Systematic review of infectious events with the Bruton tyrosine kinase inhibitor ibrutinib in the treatment of hematologic malignancies. Eur J Haematol. 2018;100(4):325-334. doi:10.1111/ejh.13020
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Reference News

[1]
Infection Risk With BTK Inhibitors Low, New CLL Study Finds
ajmc.com · Jun 28, 2024

A study in Open Forum Infectious Diseases confirms BTK inhibitors for CLL slightly increase invasive fungal infection ri...

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