Lin Jay, Siegartel Lisa R, Lingohr-Smith Melissa, Menges Brandy, Makenbaeva Dinara
Novosys Health, Green Brook, New Jersey.
Bristol-Myers Squibb, Plainsboro, New Jersey.
Clin Ther. 2017 Feb;39(2):303-310. doi: 10.1016/j.clinthera.2016.12.010. Epub 2017 Jan 5.
Although most patients with Hodgkin lymphoma (HL) respond to primary therapy, some patients experience relapses or are refractory to treatment (RR-HL). The objectives of this study were to investigate the prevalence of HL and RR-HL in the United States by using a large health care claims database.
Patients with ≥1 diagnosis for HL between January 1, 2013, and September 30, 2014 (prevalence assessment period), in the MarketScan Commercial and Medicare databases were identified. RR-HL patients were identified as any HL patient with any record for either an autologous stem cell transplantation (ASCT) or brentuximab vedotin (BV) treatment between January 1, 2010, and September 30, 2014 (entire study period). Prevalence rates of HL and RR-HL were calculated as the number of patients with HL or RR-HL divided by the total number of persons with insurance enrollment during the prevalence assessment period (January 1, 2013-September 30, 2014) in the MarketScan databases. Age- and sex-specific prevalence rates for HL and RR-HL were estimated. The estimated prevalence rates based on the claims database analysis were applied to the US national population estimates from the US Census Bureau to project the national prevalence of HL and RR-HL in the United States.
Of persons with any insurance enrollment in the MarketScan databases during the prevalence assessment period (N = 58,968,235), 24,812 (0.04%) were identified as having HL (mean age, 48.6 years) between January 1, 2013, and September 30, 2014. Of this HL population, 712 (2.87%) were identified as RR-HL patients, with 432 (1.74%) having received ASCT, 199 (0.80%) having received BV, and 81 (0.33%) having received both ASCT and BV treatments during the study period. According to the national projection according to the US Census population estimate, the overall number of persons with HL in the United States was estimated at 149,615 (469.2 per 1 million) in 2014, with 2.72% (N = 4077; 12.8 per 1 million) having RR-HL.
Among patients in the United States with HL, the proportion of RR-HL patients during the study period was estimated at <3% of the HL population.
尽管大多数霍奇金淋巴瘤（HL）患者对初始治疗有反应，但一些患者会复发或对治疗耐药（RR-HL）。本研究的目的是通过使用一个大型医疗保健索赔数据库来调查美国HL和RR-HL的患病率。
在MarketScan商业和医疗保险数据库中，识别出在2013年1月1日至2014年9月30日（患病率评估期）期间有≥1次HL诊断的患者。RR-HL患者被定义为在2010年1月1日至2014年9月30日（整个研究期）期间有自体干细胞移植（ASCT）或本妥昔单抗（BV）治疗记录的任何HL患者。HL和RR-HL的患病率计算方法为，在患病率评估期（2013年1月1日至2014年9月30日）内，HL或RR-HL患者的数量除以MarketScan数据库中有保险登记的总人数。估计了HL和RR-HL的年龄和性别特异性患病率。基于索赔数据库分析得出的估计患病率应用于美国人口普查局的美国全国人口估计数，以推算美国HL和RR-HL的全国患病率。
在患病率评估期内，MarketScan数据库中有任何保险登记的人群（N = 58,968,235）中，2013年1月1日至2014年9月30日期间有24,812人（0.04%）被确定患有HL（平均年龄48.6岁）。在这一HL人群中，712人（2.87%）被确定为RR-HL患者，其中432人（1.74%）在研究期间接受了ASCT，199人（0.80%）接受了BV治疗，81人（0.33%）同时接受了ASCT和BV治疗。根据美国人口普查局的人口估计进行的全国推算，2014年美国HL患者总数估计为149,615人（每100万人中有469.2人），其中2.72%（N = 4077；每100万人中有12.8人）患有RR-HL。
在美国患有HL的患者中，研究期间RR-HL患者的比例估计占HL人群的不到3%。
