Imbruvica 84 year old female / body aches & pain

[sunnymorning33]

My mother is 84 years old. She has taken retuxin 3x in the last 15 years. She recently started Imbruvica because her WBC was rising. She has arthritis, full knee replacement in December, & recovering from hernia's. She also has disk degenerative disease in her lower spine. My mother was nicknamed Energizer bunny & she has been on Imbruvica now a month. Her whole body hurts. Her WBC is at 75. I know Imbruvica side affects can be bone & muscle aches. She walks & rides a stationary bike 15 minutes 2x a day. This is not my mother. The aches & pains are too much. I have never seen her like this. I am looking for suggestions. She had knee surgery in Dec 2019 & hernia's Jan 2020. She was on Imbruvica for a couple of weeks in December 2019. Went off in January 2020 because of the hernia's. And now back on Imbruvica for about 3 weeks. She is taking tramodol for pain. Any suggestions?

[PlanetaryKim]

Perhaps she can talk to her doctor about dose reduction. That has helped some people and can still be fully effective in some/many cases.

[AussieNeil Administrator]

The second generation BTK inhibitor Acalabrutinib/Calquence has less side effects than Ibrutinib, which importantly for your mother, includes a much lower incidence of the arthralgia that she is experiencing. Can she switch to that treatment? Acalabrutinib was only approved by the FDA for CLL in late 2019. It's taken twice per day, 12 hours apart.

If that's not possible, she could explore the option of a reduced dose of Ibrutinib with her specialist, particularly if her weight is less than average. Ibrutinib side effects do generally reduce over time, but it's unfortunately fairly common for patients to give up taking it due to unbearable side effects, while some patients have little to no side effects!

Neil