Comparative Analysis of Pirtobrutinib vs. Ibrutinib for CLL and SLL Treatment

At the 2025 American Society of Hematology Annual Meeting, researchers reported that pirtobrutinib met the non-inferiority endpoint for overall response rate compared with ibrutinib (87.0% vs 78.5%) in the BRUIN CLL-314 trial.

Early progression free-survival also favored pirtobrutinib (86.9% vs 82.3% at 18 months), though these results remain preliminary.

Patients treated with pirtobrutinib had lower reported rates of atrial fibrillation/flutter (~2.4% vs 13.5%) and hypertension (~10.6% vs 15.1%) compared with those on with ibrutinib.

For patients with cardiovascular comorbidities, the lower cardiac event rates with pirtobrutinib are a clinically relevant consideration in selecting a BTK inhibitor, though longer-term safety and efficacy data are still evolving.