Assessing Haemostatic Safety of BTK Inhibitors-Report

This study explores the effects of BTK inhibitors, Ibrutinib (first-generation) and Zanubrutinib (second-generation), on blood clotting using ROTEM analysis. While both drugs do not affect clot initiation (CT), Ibrutinib impairs clot strength (A5, A10, MCF) due to platelet dysfunction, whereas Zanubrutinib shows minimal impact, suggesting a safer haemostatic profile. Supporting assays (APTT, PT, TCT, Factor VIII:C) confirm that neither drug disrupts secondary haemostasis, indicating that Ibrutinib’s effects are platelet-specific. The findings emphasize ROTEM’s value in identifying clotting abnormalities from BTK inhibition and its role in tailoring safer treatments for patients at risk of bleeding.