Adverse event rates and economic burden associated with purine nucleoside analogs in patients with hairy cell leukemia: a US population-retrospective claims analysis
Background Purine nucleoside analogs (PNAs) are the recommended first-line treatment for patients with hairy cell leukemia (HCL), but they are associated with adverse events (AEs). Due to a lack of real-world evidence regarding AEs that are associated with PNAs, we used commercial data to assess AE rates, AE-related health care resource utilization (HCRU), and costs among PNA-treated patients with HCL. Adults aged ≥18 years with ≥2 claims for HCL ≥30 days apart from 1 January 2006 through 31 December 2015 were included. Included patients had ≥1 claim for HCL therapy (cladribine ± rituximab or pentostatin ± rituximab [index date: first claim date]) and continuous enrollment for a ≥ 6-month baseline and ≥ 12-month follow-up period. Patient sub-cohorts were based on the occurrence of myelosuppression and opportunistic infections (OIs). Generalized linear models were used to compare HCRU and costs. Results In total, 647 PNA-treated patients were identified (mean age: 57.1 years). Myelosuppression and OI incidence were 461 and 42 per 1000 patient-years, respectively. Adjusted results indicated that those with myelosuppression had higher rates of hospitalization (47.4% vs 12.4%; P < .0001) and incurred higher mean inpatient costs ($23,517 vs $12,729; P = .011) and total costs ($57,325 vs $34,733; P = .001) as compared with those without myelosuppression. Similarly, patients with OIs had higher rates of hospitalization (53.8% vs 30.8%; P = .025) and incurred higher mean inpatient costs ($21,494 vs $11,229; P < .0001) as compared with those without OIs. Conclusions PNA therapy is highly effective but associated with significant toxicities that increase costs; these findings indicate a need for therapies with improved toxicity profiles and better risk stratification of patients at risk of developing myelosuppression and OIs..
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2020 |
---|---|
Erschienen: |
2020 |
Enthalten in: |
Zur Gesamtaufnahme - volume:15 |
---|---|
Enthalten in: |
Orphanet journal of rare diseases - 15(2020), 1 vom: 13. Feb. |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Epperla, Narendranath [VerfasserIn] |
---|
Links: |
Volltext [kostenfrei] |
---|
Themen: |
Adverse events |
---|
Anmerkungen: |
© The Author(s). 2020 |
---|
doi: |
10.1186/s13023-020-1325-9 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
SPR029505526 |
---|
LEADER | 01000caa a22002652 4500 | ||
---|---|---|---|
001 | SPR029505526 | ||
003 | DE-627 | ||
005 | 20230519113358.0 | ||
007 | cr uuu---uuuuu | ||
008 | 201007s2020 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1186/s13023-020-1325-9 |2 doi | |
035 | |a (DE-627)SPR029505526 | ||
035 | |a (SPR)s13023-020-1325-9-e | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Epperla, Narendranath |e verfasserin |4 aut | |
245 | 1 | 0 | |a Adverse event rates and economic burden associated with purine nucleoside analogs in patients with hairy cell leukemia: a US population-retrospective claims analysis |
264 | 1 | |c 2020 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a Computermedien |b c |2 rdamedia | ||
338 | |a Online-Ressource |b cr |2 rdacarrier | ||
500 | |a © The Author(s). 2020 | ||
520 | |a Background Purine nucleoside analogs (PNAs) are the recommended first-line treatment for patients with hairy cell leukemia (HCL), but they are associated with adverse events (AEs). Due to a lack of real-world evidence regarding AEs that are associated with PNAs, we used commercial data to assess AE rates, AE-related health care resource utilization (HCRU), and costs among PNA-treated patients with HCL. Adults aged ≥18 years with ≥2 claims for HCL ≥30 days apart from 1 January 2006 through 31 December 2015 were included. Included patients had ≥1 claim for HCL therapy (cladribine ± rituximab or pentostatin ± rituximab [index date: first claim date]) and continuous enrollment for a ≥ 6-month baseline and ≥ 12-month follow-up period. Patient sub-cohorts were based on the occurrence of myelosuppression and opportunistic infections (OIs). Generalized linear models were used to compare HCRU and costs. Results In total, 647 PNA-treated patients were identified (mean age: 57.1 years). Myelosuppression and OI incidence were 461 and 42 per 1000 patient-years, respectively. Adjusted results indicated that those with myelosuppression had higher rates of hospitalization (47.4% vs 12.4%; P < .0001) and incurred higher mean inpatient costs ($23,517 vs $12,729; P = .011) and total costs ($57,325 vs $34,733; P = .001) as compared with those without myelosuppression. Similarly, patients with OIs had higher rates of hospitalization (53.8% vs 30.8%; P = .025) and incurred higher mean inpatient costs ($21,494 vs $11,229; P < .0001) as compared with those without OIs. Conclusions PNA therapy is highly effective but associated with significant toxicities that increase costs; these findings indicate a need for therapies with improved toxicity profiles and better risk stratification of patients at risk of developing myelosuppression and OIs. | ||
650 | 4 | |a Hairy cell leukemia |7 (dpeaa)DE-He213 | |
650 | 4 | |a Adverse events |7 (dpeaa)DE-He213 | |
650 | 4 | |a Purine nucleoside analogs |7 (dpeaa)DE-He213 | |
650 | 4 | |a Myelosuppression |7 (dpeaa)DE-He213 | |
700 | 1 | |a Pavilack, Melissa |4 aut | |
700 | 1 | |a Olufade, Temitope |4 aut | |
700 | 1 | |a Bashyal, Richa |4 aut | |
700 | 1 | |a Li, Jieni |4 aut | |
700 | 1 | |a Kabadi, Shaum M. |4 aut | |
700 | 1 | |a Yuce, Huseyin |4 aut | |
700 | 1 | |a Andritsos, Leslie |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Orphanet journal of rare diseases |d London : BioMed Central, 2006 |g 15(2020), 1 vom: 13. Feb. |w (DE-627)SPR029480884 |w (DE-600)2225857-7 |x 1750-1172 |7 nnns |
773 | 1 | 8 | |g volume:15 |g year:2020 |g number:1 |g day:13 |g month:02 |
856 | 4 | 0 | |u https://dx.doi.org/10.1186/s13023-020-1325-9 |z kostenfrei |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_SPRINGER | ||
912 | |a SSG-OLC-PHA | ||
951 | |a AR | ||
952 | |d 15 |j 2020 |e 1 |b 13 |c 02 |