Acalabrutinib Side Effects and Management

Introduction to Acalabrutinib Side Effects

• Acalabrutinib has a more favorable cardiovascular safety profile compared to ibrutinib, with lower rates of atrial fibrillation and hypertension, and commonly causes headache, diarrhea, and bleeding events 1, 2

Common Side Effects

• Diarrhea occurs in 58% of patients 2
• Headache occurs in 39% of patients, typically resolves after 1-2 months, and can be managed with acetaminophen and caffeine supplements 1, 2
• Fatigue occurs in 10-18% of patients 2
• Pyrexia occurs in 12-21% of patients 2

Cardiovascular Side Effects

• Atrial fibrillation has an overall incidence of 4-5% and 1% grade ≥3 1
• Hypertension has an overall incidence of 3-5% and 2-3% grade ≥3 1

Bleeding Events

• Overall bleeding risk is 26-39% for any grade bleeding and 2% for grade ≥3 bleeding 1
• Monitor patients requiring antiplatelet or anticoagulant therapies and avoid concomitant warfarin use 1, 3

Infections

• Overall infection rate is 65% and grade ≥3 infections occur in 14% of patients 1
• Pneumonia and upper respiratory tract infections are most common 1, 2

Management Considerations

• For headaches, manage with analgesics (acetaminophen) and caffeine supplements 1
• For cardiovascular events, monitor for atrial fibrillation and hypertension and consider switching therapy if not medically controllable 1
• For patients on anticoagulants, evaluate benefit and risk carefully, avoid concomitant warfarin use, and monitor for signs of bleeding 1, 3