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Atrium; BeatCITE-LANCT03751410

Chronic Ibrutinib Therapy Effect on Left Atrial Function

An observational study of Atrium; Beat and Echocardiography, run by University Hospital Sestre Milosrdnice at 1 site in Croatia.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Ibrutinib is an irreversible Bruton tyrosine-kinase inhibitor. In prospective studies, the ibrutinib efficacy in the treatment of various B-cell malignancies was established. Different ibrutinib side-effects have been found: diarrhea, arthralgia, infections, neutropenia, hypertension and increased risk of bleeding. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Atrium; Beat, Echocardiography, Physiology
How many people
40 participants
Where
1 siteCroatia
Study dates
1 Dec 2018to 4 Mar 2023
How long will I take part?
12 Months
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: All consecutive patients with haemato-oncologic diseases (including chronic lymphocytic leukemia, Mantle-cell lymphoma, Waldenstrom macroglobulinaemia) prescribed with chronic ibrutinib therapy, who are able to understand and sign informed consent, will be enrolled.

Who may be able to join

  • patients with haemato-oncologic diseases (including chronic lymphocytic leukemia, Mantle-cell lymphoma, Waldenstrom macroglobulinaemia, etc.)
  • patients prescribed with chronic ibrutinib therapy
  • patients who are able to understand and sign informed consent

Who cannot join

  • patients with haemato-oncologic diseases who were prescribed with concomitant chemotherapy which can impact left atrial function
  • patients < 18 years old
  • patients with known or at initial echocardiography established dilated cardiomyopathy with left ventricular ejection fraction < 35%
  • patients with permanent atrial fibrillation and dilated left atrium or dilated both atriums
  • patients implanted with cardiac implantable electronic devices
  • patients who underwent cardiac surgery
Show all 13Show fewer
  • patients with congenital heart diseases (surgically corrected or not)
  • patients with severe valvular pathology
  • patients with terminal renal disease
  • patients with chronic obstructive pulmonary disease - GOLD grade 4
  • patients with life expectancy < 12 months
  • patients not willing to undergo clinical follow-up or sign informed consent
  • patients recruited in another clinical study

Trial locations and contacts

1 site in 1 country.

Croatia1 site
  • Sestre milosrdnice University Hospital

    Zagreb, 10000

Other trials in Croatia

About this study

Official title: Long-term Effect of Chronic Ibrutinib Therapy on Left Atrial Function

Ibrutinib is an irreversible Bruton tyrosine-kinase inhibitor. In prospective studies, the ibrutinib efficacy in the treatment of various B-cell malignancies was established. Different ibrutinib side-effects have been found: diarrhea, arthralgia, infections, neutropenia, hypertension and increased risk of bleeding. Most of the mentioned side-effects were <3rd degree of severity and mostly didn't require dose adjustment or therapy discontinuation. Also, there was an increase in the incidence of atrial fibrillation (AFib) (6-16%). The AFib pathogenesis in this patient population is not clarified, but there are indications that ibrutinib inhibits phosphoinositide-3-kinase (PI3K)-Akt signal-pathway expressed in the myocytes. Regardless of the molecular pathogenesis, the clinical effect of ibrutinib on the myocardium, especially the left atrium, has not been studied. Hence, the aim of this study is to determine the ibrutinib effect on echocardiographic parameters of left atrial function.

This study will be performed as a clinical, prospective, observational cohort study with a structured follow-up period of 12 months. All consecutive patients with hemato-oncologic diseases (including chronic lymphocytic leukemia, Mantle-cell lymphoma, Waldenstrom macroglobulinemia, etc.) prescribed with chronic ibrutinib therapy, who are able to understand and sign informed consent, will be enrolled. Primary objective is change of the left atrial function measured by the decrease of the left atrial strain deformation > 10%.

Read more

Recruiting should not exceed 12 months with the minimal follow-up period of 12 months (24 months in total). Standardized statistical methods and tests will be done using SPSS Version 22.0 or newer.

This unique study offers the possibility to show the long-term effect of chronic ibrutinib therapy on left atrial function assessed by transthoracic echocardiography. This observational data is needed to further refine the treatment of these patients and to prevent possible side-effects of ibrutinib which could endanger this specific patient population.

Keywords
ibrutinib, echocardiography, left atrium, function, long-term

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. left atrial function change

    change of the left atrial function measured by the decrease of the left atrial strain deformation > 10% assessed by transthoracic echocardiography

    Measured: initial measurement, 3 months, 6 months and 12 months after initiation of ibrutinib therapy

Secondary outcomes (6)
  1. left ventricular ejection fraction change

    measurement of left ventricular systolic function change assessed by transthoracic echocardiography - method according to Simpson and Teicholz

    Measured: initial measurement, 3 months, 6 months and 12 months after initiation of ibrutinib therapy

  2. left ventricular diastolic function change

    measurement of left ventricular diastolic function change assessed by transthoracic echocardiography (E/A and E/E')

    Measured: initial measurement, 3 months, 6 months and 12 months after initiation of ibrutinib therapy

  3. left atrial volume change

    2D and 3D left atrial volume change assessed by transthoracic echocardiography + left atrial dimension in PLAX and 4 chamber projection

    Measured: initial measurement, 3 months, 6 months and 12 months after initiation of ibrutinib therapy

  4. P wave duration change

    P wave duration and PQ interval duration change assessed in 12-lead electrocardiogram (in milliseconds)

    Measured: initial measurement, 3 months, 6 months and 12 months after initiation of ibrutinib therapy

  5. left atrial pump function change

    left atrial ejection fractionchange assessed by transthoracic echocardiography (doppler strain measurement method)

    Measured: initial measurement, 3 months, 6 months and 12 months after initiation of ibrutinib therapy

  6. atrial fibrillation incidence

    incidence of paroxysmal atrial fibrillation assessed by symptoms + ECG or 24-hours Holter-ECG

    Measured: initial measurement, 3 months, 6 months and 12 months after initiation of ibrutinib therapy

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Nov 2018
  2. Study start1 Dec 2018
  3. Primary completion4 Mar 2023
  4. Study completion4 Mar 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
40 participants (actual)
Target duration
12 Months
IDs, dates and publications
ClinicalTrials.gov ID
NCT03751410
Sponsor's protocol ID
UHS-2
Other IDs
U1111-1221-9732
Acronym
CITE-LA
Status last verified
Oct 2023
First submitted
19 Nov 2018
Last updated
17 Oct 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Deeks ED. Ibrutinib: A Review in Chronic Lymphocytic Leukaemia. Drugs. 2017 Feb;77(2):225-236. doi: 10.1007/s40265-017-0695-3.

    PubMed 28105602
  • Byrd JC, Brown JR, O'Brien S, Barrientos JC, Kay NE, Reddy NM, Coutre S, Tam CS, Mulligan SP, Jaeger U, Devereux S, Barr PM, Furman RR, Kipps TJ, Cymbalista F, Pocock C, Thornton P, Caligaris-Cappio F, Robak T, Delgado J, Schuster SJ, Montillo M, Schuh A, de Vos S, Gill D, Bloor A, Dearden C, Moreno C, Jones JJ, Chu AD, Fardis M, McGreivy J, Clow F, James DF, Hillmen P; RESONATE Investigators. Ibrutinib versus ofatumumab in previously treated chronic lymphoid leukemia. N Engl J Med. 2014 Jul 17;371(3):213-23. doi: 10.1056/NEJMoa1400376. Epub 2014 May 31.

    PubMed 24881631
  • Thompson PA, Burger JA. Bruton's tyrosine kinase inhibitors: first and second generation agents for patients with Chronic Lymphocytic Leukemia (CLL). Expert Opin Investig Drugs. 2018 Jan;27(1):31-42. doi: 10.1080/13543784.2018.1404027. Epub 2017 Nov 15.

    PubMed 29125406
  • Wierda WG, Zelenetz AD, Gordon LI, Abramson JS, Advani RH, Andreadis CB, Bartlett N, Byrd JC, Caimi P, Fayad LE, Fisher RI, Glenn MJ, Habermann TM, Harris NL, Hernandez-Ilizaliturri F, Hoppe RT, Horwitz SM, Kaminski MS, Kelsey CR, Kim YH, Krivacic S, LaCasce AS, Martin MG, Nademanee A, Porcu P, Press O, Rabinovitch R, Reddy N, Reid E, Roberts K, Saad AA, Snyder ED, Sokol L, Swinnen LJ, Vose JM, Yahalom J, Dwyer MA, Sundar H. NCCN Guidelines Insights: Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma, Version 1.2017. J Natl Compr Canc Netw. 2017 Mar;15(3):293-311. doi: 10.6004/jnccn.2017.0030.

    PubMed 28275031
  • Burger JA, Tedeschi A, Barr PM, Robak T, Owen C, Ghia P, Bairey O, Hillmen P, Bartlett NL, Li J, Simpson D, Grosicki S, Devereux S, McCarthy H, Coutre S, Quach H, Gaidano G, Maslyak Z, Stevens DA, Janssens A, Offner F, Mayer J, O'Dwyer M, Hellmann A, Schuh A, Siddiqi T, Polliack A, Tam CS, Suri D, Cheng M, Clow F, Styles L, James DF, Kipps TJ; RESONATE-2 Investigators. Ibrutinib as Initial Therapy for Patients with Chronic Lymphocytic Leukemia. N Engl J Med. 2015 Dec 17;373(25):2425-37. doi: 10.1056/NEJMoa1509388. Epub 2015 Dec 6.

    PubMed 26639149
  • Kaur V, Swami A. Ibrutinib in CLL: a focus on adverse events, resistance, and novel approaches beyond ibrutinib. Ann Hematol. 2017 Jul;96(7):1175-1184. doi: 10.1007/s00277-017-2973-2. Epub 2017 Mar 24.

    PubMed 28342031
  • O'Brien S, Hillmen P, Coutre S, Barr PM, Fraser G, Tedeschi A, Burger JA, Dilhuydy MS, Hess G, Moreno C, Cramer P, Liu E, Chang S, Vermeulen J, Styles L, Howes A, James DF, Patel K, Graef T, Valentino R. Safety Analysis of Four Randomized Controlled Studies of Ibrutinib in Patients With Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma or Mantle Cell Lymphoma. Clin Lymphoma Myeloma Leuk. 2018 Oct;18(10):648-657.e15. doi: 10.1016/j.clml.2018.06.016. Epub 2018 Jun 28.

    PubMed 30061088
  • Reda G, Fattizzo B, Cassin R, Mattiello V, Tonella T, Giannarelli D, Massari F, Cortelezzi A. Predictors of atrial fibrillation in ibrutinib-treated CLL patients: a prospective study. J Hematol Oncol. 2018 Jun 11;11(1):79. doi: 10.1186/s13045-018-0626-0.

    PubMed 29891001
  • Boriani G, Corradini P, Cuneo A, Falanga A, Foa R, Gaidano G, Ghia PP, Martelli M, Marasca R, Massaia M, Mauro FR, Minotti G, Molica S, Montillo M, Pinto A, Tedeschi A, Vitolo U, Zinzani PL. Practical management of ibrutinib in the real life: Focus on atrial fibrillation and bleeding. Hematol Oncol. 2018 Oct;36(4):624-632. doi: 10.1002/hon.2503. Epub 2018 Mar 7.

    PubMed 29512173
  • Mato AR, Clasen S, Pickens P, Gashonia L, Rhodes J, Svoboda J, Hughes M, Nabhan C, Ali N, Schuster S, Carver J. Left atrial abnormality (LAA) as a predictor of ibrutinib-associated atrial fibrillation in patients with chronic lymphocytic leukemia. Cancer Biol Ther. 2018 Jan 2;19(1):1-2. doi: 10.1080/15384047.2017.1394554. Epub 2017 Dec 27.

    PubMed 29281559
  • Leong DP, Caron F, Hillis C, Duan A, Healey JS, Fraser G, Siegal D. The risk of atrial fibrillation with ibrutinib use: a systematic review and meta-analysis. Blood. 2016 Jul 7;128(1):138-40. doi: 10.1182/blood-2016-05-712828. Epub 2016 May 31. No abstract available.

    PubMed 27247135
  • Kolacevic Zeljkovic M, Basic-Kinda S, Carzavec D, Vodanovic M, Mandac Smoljanovic I, Jaksic O, Novak M, Ostojic-Kolonic S, Dujmovic D, Pejsa V, Aurer I, Bulj N. Longitudinal changes in left atrial function during chronic ibrutinib therapy: a prospective observational study. Front Cardiovasc Med. 2026 Aug 26;13:1914493. doi: 10.3389/fcvm.2026.1914493. eCollection 2026.

    PubMed 42718685

Questions about this trial

What is this clinical trial studying?

An observational study of Atrium; Beat and Echocardiography, run by University Hospital Sestre Milosrdnice at 1 site in Croatia.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 17 Oct 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Croatia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

left atrial function change (time frame: initial measurement, 3 months, 6 months and 12 months after initiation of ibrutinib therapy). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03751410, which also lists 12 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Oct 2023.

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