Pulmonary vascular disease & thromboembolism
Second- and Third-Generation BCR-ABL Tyrosine Kinase Inhibitors and the Risk of Pulmonary Arterial Hypertension: A Prevalent New-User Design
Authors' conclusion
This study, designed to emulate a randomized trial, suggests that, in French patients with chronic myeloid leukemia treated with BCR-ABL TKIs, dasatinib use is associated with a higher risk of PAH compared with imatinib, while bosutinib and ponatinib exposure may aggravate or trigger a recurrence of PAH in patients with preexisting dasatinib exposure.
Study context
- Population
- Adults initiating BCR-ABL tyrosine kinase inhibitors (TKIs), French national health care database, 2008–2024each matched with imatinib users
- Exposure
- Second- and third-generation BCR-ABL TKIs vs imatinib
- Dasatinibn = 6,625
- Nilotinibn = 5,205
- Bosutinibn = 2,421
- Ponatinibn = 1,358
- Asciminibn = 922
- Outcome
- New onset of PAH
Methodological detailsprevalent new-user design, time-conditional propensity-score matched, French national health care database
- Prevalent new-user design
- Time-conditional propensity-score matched
- French national health care database
Main finding
As reported in the abstract
New-onset PAH
Each group vs imatinibHazard ratio (95% CI)
Dasatinib
8.89(5.30–14.92)
Bosutinibmost cases in patients previously exposed to dasatinib
10.76(4.68–24.73)
Ponatinibmost cases in patients previously exposed to dasatinib
7.74(2.33–25.70)
Observational data: associations, not effects.
Original publication
Second- and Third-Generation BCR-ABL Tyrosine Kinase Inhibitors and the Risk of Pulmonary Arterial Hypertension: A Prevalent New-User Design. Circulation. Published 12 February 2026. doi:10.
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