Private Practice Hematology and Oncology, Kaiserslautern, Germany.
TEVA Pharmaceuticals Inc., Parsippany, NJ, USA.
Support Care Cancer. 2022 Nov;30(11):9317-9327. doi: 10.1007/s00520-022-07353-3. Epub 2022 Sep 8.
We assessed the occurrence of neutropenia and febrile neutropenia (FN) and the associated healthcare resource in cancer patients receiving myelosuppressive chemotherapy in combination with pegfilgrastim versus lipegfilgrastim.
This is a retrospective analysis using a German health insurance claims database. Adults receiving chemotherapy with a prescription code for pegfilgrastim (n = 734) or lipegfilgrastim (n = 346) were observed over a 1-year follow-up period. Patient subgroups were analyzed according to cancer type and FN risk. FN risk was based on the chemotherapy regimen and any additional neutropenia risk factors. Outcomes were adjusted via regression analysis.
Most patients were classified as high FN risk (70.0% pegfilgrastim; 65.6% lipegfilgrastim cohort). The mean age was 58.2 years in the pegfilgrastim cohort and 58.0 years in the lipegfilgrastim cohort, with more female patients than male patients (77.3% vs 79.8%, respectively), and the majority had breast cancer (64.9% and 68.8%, respectively). Overall, 10.0% and 10.4% of patients receiving pegfilgrastim or lipegfilgrastim experienced a neutropenia event (p = 0.82), with 4.4% and 3.5% of patients experiencing a FN event (p = 0.49). The mean neutropenia event-related healthcare costs were €604 and €441 for the pegfilgrastim and lipegfilgrastim cohorts; among patients with lymphoma, these costs were significantly greater (p = 0.03) with pegfilgrastim (€1,612) versus lipegfilgrastim (€382). The mean all-cause hospitalizations were significantly (p < 0.01) higher for lymphoma patients receiving pegfilgrastim (2.76) versus lipegfilgrastim (1.60).
Overall, patients treated with pegfilgrastim and lipegfilgrastim were comparable in terms of neutropenia occurrences in the 1-year follow-up. In patients with lymphoma, neutropenia event-related healthcare costs and all-cause hospitalizations were significantly higher with pegfilgrastim compared with lipegfilgrastim in this study; however, this should be interpreted with caution in light of the limited sample size and the absence of clinical information.
我们评估了接受骨髓抑制化疗联合培非格司亭或利培格司亭的癌症患者中性粒细胞减少症和发热性中性粒细胞减少症（FN）的发生情况以及相关的医疗资源使用情况。
这是一项使用德国医疗保险索赔数据库的回顾性分析。在为期 1 年的随访期间，观察接受培非格司亭（n=734）或利培格司亭（n=346）化疗的成年患者。根据癌症类型和 FN 风险对患者亚组进行分析。FN 风险基于化疗方案和任何其他中性粒细胞减少风险因素。通过回归分析调整结局。
大多数患者被归类为高 FN 风险（培非格司亭组 70.0%；利培格司坦组 65.6%）。培非格司亭组的平均年龄为 58.2 岁，利培格司坦组为 58.0 岁，女性患者多于男性患者（分别为 77.3%和 79.8%），大多数患者患有乳腺癌（分别为 64.9%和 68.8%）。总体而言，接受培非格司亭或利培格司坦治疗的患者中，10.0%和 10.4%发生中性粒细胞减少事件（p=0.82），4.4%和 3.5%发生 FN 事件（p=0.49）。培非格司亭和利培格司坦组中性粒细胞减少事件相关的医疗费用平均分别为 604 欧元和 441 欧元；在淋巴瘤患者中，培非格司亭的费用显著更高（p=0.03），为 1612 欧元，而利培格司坦为 382 欧元。接受培非格司亭治疗的淋巴瘤患者的所有原因住院治疗（p<0.01）明显高于接受利培格司坦治疗的患者（2.76 次与 1.60 次）。
在 1 年的随访中，接受培非格司亭和利培格司坦治疗的患者中性粒细胞减少症的发生情况相当。在淋巴瘤患者中，与利培格司坦相比，培非格司亭治疗的中性粒细胞减少症相关的医疗费用和全因住院治疗显著更高；然而，鉴于样本量有限且缺乏临床信息，应谨慎解释这些结果。
