Impact of atrial fibrillation in onco-hematological patients in Europe: a targeted literature review

ABSTRACT

Introduction

Atrial fibrillation (AF) is a common complication in cancer patients, and the increased risk associated with certain therapies poses a major challenge. The objective was to determine the clinical and economic burden of AF in onco-hematological patients in Europe.

Areas covered

A targeted literature review was completed for observational, retrospective and case studies, and reviews on AF in onco-hematology published between January 2010 and 2022 in PubMed, Science Direct, Medes and IBECS. The search was based on epidemiology, cost, health-related quality of life (HRQoL), disease burden and management, and patient journey. Thirty-one studies fulfilled eligibility criteria. Annual incidence of AF during treatment varies up to 25%, and increased with first-generation Bruton tyrosine kinase inhibitors (BTKi). Risk factors include age ≥65, prior AF or hypertension, hyperlipidemia and ibrutinib use. Complications are managed with anticoagulants and/or antiarrhythmics, and regular monitoring. When AF is no longer controllable, dose reduction or discontinuation is recommended. No data on costs, HRQoL and patient journey were identified.

Expert Opinion

There is scarce and heterogeneous information on AF in onco-hematology in Europe. Available evidence reports a higher risk of AF associated with first-generation BTKi. Further studies are needed to understand the burden of AF in these patients.

KEYWORDS:

• Atrial fibrillation
• hematologic neoplasms
• review
• tyrosine protein kinase inhibitors

Article highlights

• This review contributes to the knowledge of atrial fibrillation on epidemiology, disease burden and disease management in patients with hematologic malignancies from a comprehensive and holistic perspective in the European setting.

• There is scarce and heterogeneous information available on atrial fibrillation in onco-hematology in Europe, and that available evidence reports a higher risk of AF associated with first-generation Bruton tyrosine kinase inhibitors.

• This study tries to give clinicians general perspective on the burden and risk factors of atrial fibrillation in patients with hematological malignancies and how they can be managed in Europe.

Declaration of interest

F Escalante-Barrigon is a consultant or advisor for Amgen, BeiGene, BMS-Celgene, GSK, Janssen, Sanofi and Takeda, and has received honoraria from Amgen, Janssen and Sanofi. N Bahar, C Bas, K Yang, and B Tang are employed by BeiGene. E Pomares and A García are employed by PharmaLex Spain, a consultant company specialized in health economics and outcomes research and received financial support from BeiGene for the development of this study. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer Disclosures

A peer reviewer on this manuscript works for Bristol Myers Squibb, a company that manufacturers and promotes apixaban, an oral anticoagulant indicated to prevent strokes in patients with Atrial Fibrillation. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17474086.2023.2223926

Additional information

Funding

This paper was supported by BeiGene.