González Rosa V, Gutiérrez Nicolás F, Gavira Moreno R, Viña Romero M M, Moreno Carvajal M T, Gázquez Pérez R
Hospital General Jerez de la Frontera. Cádiz.
Farm Hosp. 2013 Nov-Dec;37(6):434-40. doi: 10.7399/FH.2013.37.6.775.
To analyze adherence and toxicity of tyrosine kinase inhibitor (TKIs) therapy in patients diagnosed with chronic myeloid leukemia (CML).
A 18-months retrospective observational study (January 2011-June 2012) which included all patients diagnosed with CML in a secondary hospital (550 beds) and were treated with imatinib, dasatinib or nilotinib. It was collected the following variables: sex, age at diagnosis, years of treatment and side effects. Adherence was evaluated using SMAQ questionnaire and recording dispensations.
25 patients were included and all but two (92.0%) experienced side effects to imatinib,83.3% to dasatinib and 66.7% to nilotinib. The average adherence was 71.3%. There was identified as possible parameters of lack of adherence the female patients (55.6 % vs. 66.7%, p = 0.586), older than 50 (55.6 % vs. 83.3 %, p = 0.125), more than four years of treatment (70.0 % vs. 57.1 %, p = 0.521) and the presence of certain side effects (gastrointestinal disorders and musculoeskeletal pain).
Almost one third of patients were considered nonadherent to therapy. Although the sample size did not allow us to establish a statistically significant relation between adherence and the variables analyzed, the clinical relevance of these results show the importance of future studies with larger populations to confirm the trends established in this study.
分析酪氨酸激酶抑制剂(TKIs)治疗慢性髓性白血病(CML)患者的依从性和毒性。
一项为期18个月的回顾性观察研究(2011年1月至2012年6月),纳入了一家二级医院(550张床位)所有诊断为CML且接受伊马替尼、达沙替尼或尼洛替尼治疗的患者。收集了以下变量:性别、诊断时年龄、治疗年限和副作用。使用SMAQ问卷并记录配药情况来评估依从性。
纳入25例患者,除2例(92.0%)外,所有患者均出现伊马替尼副作用,83.3%出现达沙替尼副作用,66.7%出现尼洛替尼副作用。平均依从性为71.3%。确定女性患者(55.6%对66.7%,p = 0.586)、年龄大于50岁(55.6%对83.3%,p = 0.125)、治疗超过四年(70.0%对57.1%,p = 0.521)以及存在某些副作用(胃肠道疾病和肌肉骨骼疼痛)可能是依从性差的参数。
近三分之一的患者被认为治疗依从性差。尽管样本量不足以使我们确定依从性与所分析变量之间具有统计学意义的关系,但这些结果的临床相关性表明,未来进行更大规模人群研究以证实本研究确立的趋势具有重要意义。