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Risk of Atrial Fibrillation and Bleeding Diathesis Associated With Ibrutinib Treatment: A Systematic Review and Pooled Analysis of Four Randomized Controlled.

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Presentation on theme: "Risk of Atrial Fibrillation and Bleeding Diathesis Associated With Ibrutinib Treatment: A Systematic Review and Pooled Analysis of Four Randomized Controlled."— Presentation transcript:

1 Risk of Atrial Fibrillation and Bleeding Diathesis Associated With Ibrutinib Treatment: A Systematic Review and Pooled Analysis of Four Randomized Controlled Trials  Seongseok Yun, Nicole D. Vincelette, Utkarsh Acharya, Ivo Abraham  Clinical Lymphoma, Myeloma and Leukemia  Volume 17, Issue 1, Pages e13 (January 2017) DOI: /j.clml Copyright © 2016 Elsevier Inc. Terms and Conditions

2 Figure 1 Trial Selection Process for Systematic Review and Pooled Analysis Clinical Lymphoma, Myeloma and Leukemia  , e13DOI: ( /j.clml ) Copyright © 2016 Elsevier Inc. Terms and Conditions

3 Figure 2 Analysis of Risk Ratio of Afib/Aflutter and Bleeding. Forest Plots of Risk Ratios for Serious Afib/Aflutter (A), All-Grade Afib/Aflutter (B), Major Bleeding (C), and All-Grade Bleeding (D) From All Available Data. Size of Data Markers (Square) Corresponds to Weight of Study in Pooled Analysis. Effects of Interventions are Calculated by Fixed Effects Model Abbreviations: Afib = atrial fibrillation; Aflutter = atrial flutter. Clinical Lymphoma, Myeloma and Leukemia  , e13DOI: ( /j.clml ) Copyright © 2016 Elsevier Inc. Terms and Conditions

4 Supplemental Figure 1 Funnel Plot Evaluating Evidence of Publication Bias. Black circle = CLL/SLL trial; green square = MCL trial Abbreviations: CLL/SLL = chronic lymphocytic leukemia/small lymphocytic leukemia; MCL = mantle-cell lymphoma. Clinical Lymphoma, Myeloma and Leukemia  , e13DOI: ( /j.clml ) Copyright © 2016 Elsevier Inc. Terms and Conditions

5 Supplemental Figure 2 Subgroup Analysis of Serious Afib/Aflutter. Forest Plots of RR Difference for Serious Afib/Aflutter From All Available Data. Size of Data Markers (Square) Corresponds to Weight of Study in Analysis. Effects of Interventions Are Calculated With Fixed Effects Model. Criteria Used for Subgroup Analysis Include Underlying Pathology, Treatment Setting, Ibrutinib Dose, and Duration of Ibrutinib Exposure Abbreviations: Afib = atrial fibrillation; Aflutter = atrial flutter. Clinical Lymphoma, Myeloma and Leukemia  , e13DOI: ( /j.clml ) Copyright © 2016 Elsevier Inc. Terms and Conditions

6 Supplemental Figure 2 Subgroup Analysis of Serious Afib/Aflutter. Forest Plots of RR Difference for Serious Afib/Aflutter From All Available Data. Size of Data Markers (Square) Corresponds to Weight of Study in Analysis. Effects of Interventions Are Calculated With Fixed Effects Model. Criteria Used for Subgroup Analysis Include Underlying Pathology, Treatment Setting, Ibrutinib Dose, and Duration of Ibrutinib Exposure Abbreviations: Afib = atrial fibrillation; Aflutter = atrial flutter. Clinical Lymphoma, Myeloma and Leukemia  , e13DOI: ( /j.clml ) Copyright © 2016 Elsevier Inc. Terms and Conditions

7 Supplemental Figure 3 Subgroup Analysis of Major Bleeding. Forest Plots of Relative Risk Difference for Major Bleeding From All Available Data. Size of Data Markers (Square) Corresponds to Weight of Study in Analysis. Effects of Interventions Are Calculated With Fixed Effects Model. Criteria Used for Subgroup Analysis Include Underlying Pathology, Treatment Setting, Ibrutinib Dose, and Duration of Ibrutinib Exposure Clinical Lymphoma, Myeloma and Leukemia  , e13DOI: ( /j.clml ) Copyright © 2016 Elsevier Inc. Terms and Conditions

8 Supplemental Figure 3 Subgroup Analysis of Major Bleeding. Forest Plots of Relative Risk Difference for Major Bleeding From All Available Data. Size of Data Markers (Square) Corresponds to Weight of Study in Analysis. Effects of Interventions Are Calculated With Fixed Effects Model. Criteria Used for Subgroup Analysis Include Underlying Pathology, Treatment Setting, Ibrutinib Dose, and Duration of Ibrutinib Exposure Clinical Lymphoma, Myeloma and Leukemia  , e13DOI: ( /j.clml ) Copyright © 2016 Elsevier Inc. Terms and Conditions

9 Supplemental Figure 4 One-Way Sensitivity Test for Primary Outcomes. One-Way Sensitivity Analyses for Serious Afib/Aflutter and Major Bleeding Were Performed by Removing a Single Study at Time. Size of Data Markers (Square) Corresponds to Weight of Study in Analysis. Effects of Interventions Are Calculated With Fixed Effects Model. Removing Single Study Did Not Affect Overall Primary Outcomes Abbreviations: Afib = atrial fibrillation; Aflutter = atrial flutter. Clinical Lymphoma, Myeloma and Leukemia  , e13DOI: ( /j.clml ) Copyright © 2016 Elsevier Inc. Terms and Conditions

10 Supplemental Figure 4 One-Way Sensitivity Test for Primary Outcomes. One-Way Sensitivity Analyses for Serious Afib/Aflutter and Major Bleeding Were Performed by Removing a Single Study at Time. Size of Data Markers (Square) Corresponds to Weight of Study in Analysis. Effects of Interventions Are Calculated With Fixed Effects Model. Removing Single Study Did Not Affect Overall Primary Outcomes Abbreviations: Afib = atrial fibrillation; Aflutter = atrial flutter. Clinical Lymphoma, Myeloma and Leukemia  , e13DOI: ( /j.clml ) Copyright © 2016 Elsevier Inc. Terms and Conditions

11 Supplemental Figure 5 Analyses Using Data From Original Reports
Clinical Lymphoma, Myeloma and Leukemia  , e13DOI: ( /j.clml ) Copyright © 2016 Elsevier Inc. Terms and Conditions


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