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December 8, 2025Blood

Number of patients needed to treat to prevent one atrial fibrillation event with zanubrutinib versus ibrutinib and acalabrutinib in B-cell malignancies

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Authors

TMTalha MunirPSPaolo SportolettiKYKeri Yang

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Overview

NNT estimates show treating 11 patients with zanubrutinib prevents one AFib event compared to ibrutinib, indicating cardiovascular safety benefits for B-cell malignancies.

Key Points

  • This research estimates the number of patients needed to treat with zanubrutinib to prevent atrial fibrillation compared to ibrutinib.
  • Utilized a systematic review and network meta-analysis to assess cardiovascular safety of BTK inhibitors
  • Calculated baseline incidence probability of AFib with zanubrutinib using safety data from clinical trials
  • Estimated absolute risk difference and number needed to treat (NNT) for comparisons between zanubrutinib, ibrutinib, and acalabrutinib
  • Conducted probabilistic sensitivity analyses using Monte Carlo simulation for robustness of findings
  • NNT of 11 for zanubrutinib versus ibrutinib, suggesting treating 11 prevents one AFib event
  • NNT of 24 for zanubrutinib versus acalabrutinib
  • Probabilistic sensitivity analysis confirmed NNT findings with 95% CI for zanubrutinib vs ibrutinib as 9 to 14
  • Clinical value of zanubrutinib is emphasized in decision-making related to cardiovascular safety

Cite This Study

Munir et al. (2025) studied this question.

synapsesocial.com/papers/693624dd4fa91c937236d1cchttps://doi.org/10.1182/blood-2025-8024
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Adverse event profiles of acalabrutinib and zanubrutinib in chronic lymphocytic leukemia: A real-world comparison2025 · 1 citations
  2. 2Ibrutinib and acalabrutinib use and risk of incident atrial fibrillation: a propensity-matched analysis2025
  3. 3Incidence of cardiac events associated with next-generation bruton tyrosine kinase (BTK) inhibitors compared to control in hematologic malignancies: A meta-analysis of randomized trials2025
  4. 4Number of cardiac deaths associated with ibrutinib versus zanubrutinib for the treatment of chronic lymphocytic leukemia: A European risk-based estimation2025
  5. 5Indirect comparison of efficacy of zanubrutinib vs ibrutinib for the treatment of relapsed/refractory mantle cell lymphoma2025 · 1 citations