布鲁顿酪氨酸激酶 (BTK) 抑制剂在 B 细胞淋巴增殖性疾病的靶向治疗中发挥着重要作用。然而，不良事件可能会限制许多患者的正确治疗过程。本研究的目的是比较第一代 BTK 抑制剂依鲁替尼与第二代 Acalabrutinib 治疗的慢性淋巴细胞白血病 (CLL) 或小细胞淋巴细胞淋巴瘤 (SLL) 患者发生心血管和非心血管不良事件的风险。使用来自协作跨国网络的真实世界数据。我们使用来自网络 (TriNetX) 的数据，该网络涵盖全球 100 多个医疗保健组织。在分析之前，我们查询了过去十年内接受依鲁替尼或阿卡替尼治疗的年龄≥18岁慢性淋巴细胞白血病或小细胞淋巴瘤患者的数据库。我们使用倾向评分匹配来平衡群组。计算以下结果的 3 年累积发生率和风险比：心房扑动或颤动、其他心律失常、心力衰竭、缺血性中风或外周栓塞、急性冠脉综合征、出血和败血症。我们比较了每组 2,107 名患者。在 3 年随访期间，150 名（7.1%）acalabrutinib 患者和 310 名（14.7%）ibrutinib 患者出现心房颤动或扑动（风险比，0.68，95% CI 0.55-0.84）。 acalabrutinib 组有 342 名患者（16.3%）发生新发高血压，ibrutinib 组有 584 名患者（27.7%）发生新发高血压（风险比 0.81，95% CI 0.66-0.98）。 acalabrutinib 组有 136 名患者 (6.5%) 被诊断为脓毒症，而 ibrutinib 组有 239 名患者 (11.3%) 被诊断为脓毒症（风险比 0.77，95 CI 0.60-0.98）。两组在其他不良事件方面没有显着差异。在使用来自电子医疗登记册的真实世界数据的大型回顾性队列中，接受 acalabrutinib 治疗的 CLL 或 SLL 患者比接受 ibrutinib 治疗的患者具有更好的心血管和非心血管安全性，且心房扑动或颤动的风险较低。发病性动脉高血压和脓毒症。© 2024。作者获得 Springer-Verlag GmbH 德国（Springer Nature 旗下公司）的独家许可。

Bruton tyrosine kinase (BTK) inhibitors play an important role in targeted treatment of B-cell lymphoproliferative disorders. However, adverse events may limit the proper course of treatment in many patients. The purpose of this study is to compare the risk of cardiovascular and non-cardiovascular adverse events in patients with chronic lymphocytic leukemia (CLL) or small cell lymphocytic lymphoma (SLL) treated with the first-generation BTK inhibitor ibrutinib versus second-generation acalabrutinib, using real-world data from a collaborative multinational network. We used data from the network (TriNetX), which encompasses more than 100 healthcare organizations worldwide. We queried the database for patients aged ≥ 18 years with chronic lymphocytic leukemia or small-cell lymphomas treated with ibrutinib or acalabrutinib in the past ten years before the analysis. We used propensity score matching to balance the cohorts. The 3-year cumulative incidences and hazard ratios for the following outcomes were calculated: atrial flutter or fibrillation, other arrhythmias, heart failure, ischemic stroke or peripheral embolism, acute coronary syndrome, bleeding, and sepsis. We compared 2,107 patients in each group. Atrial fibrillation or flutter occurred in 150 (7.1%) patients with acalabrutinib and 310 (14.7%) patients with ibrutinib during the 3-year follow-up (hazard ratio, 0.68, 95% CI 0.55-0.84). New-onset hypertension occurred in 342 (16.3%) patients in the acalabrutinib group and 584 (27.7%) patients in the ibrutinib group (hazard ratio 0.81, 95% CI 0.66-0.98). Sepsis was diagnosed in 136 (6.5%) patients in the acalabrutinib group versus 239 (11.3%) patients in the ibrutinib group (hazard ratio 0.77, 95 CI 0.60-0.98). The two groups had no significant differences concerning the other adverse events. In a large retrospective cohort using real-world data from electronic medical registers, patients with CLL or SLL treated with acalabrutinib had a better cardiovascular and non-cardiovascular safety profile than those treated with ibrutinib, with lower risks of atrial flutter or fibrillation, new-onset arterial hypertension, and sepsis.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.