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达沙替尼治疗达沙替尼治疗后发生胸腔积液的慢性髓性白血病患者的治疗模式分析。

An Analysis of Dasatinib Treatment Patterns in Patients with Chronic Myeloid Leukemia after Experiencing Pleural Effusion during Dasatinib Therapy.

机构信息

Bristol Myers Squibb, Princeton, New Jersey, USA.

PHAR (Partnership for Health Analytic Research), LLC, Beverly Hills, California, USA.

出版信息

Acta Haematol. 2023;146(4):259-266. doi: 10.1159/000530512. Epub 2023 Apr 10.

Abstract

INTRODUCTION

Treatment with dasatinib for chronic myeloid leukemia (CML) has been associated with development of pleural effusion; however, data regarding its optimal management are limited. We examined treatment patterns and healthcare resource utilization (HCRU) and costs among patients with CML treated with dasatinib who experienced a subsequent pleural effusion.

METHODS

Adults with CML and ≥1 pharmacy claim for dasatinib in 2015-2018 who experienced pleural effusion after dasatinib were identified using data from claims databases.

RESULTS

Overall, 123 patients were eligible. After 1 year, of the 38.2% of patients with a dose modification, 72.3% did not switch treatment; among these patients, 70.6% continued treatment. Among patients with a stable dose after pleural effusion (61.8%), 57.9% later switched to another TKI. The mean (SD) duration of dasatinib treatment after pleural effusion was 262.0 (124.0) days for patients with a dose modification versus 149.1 (155.2) days for those with a stable dose (p < 0.001). HCRU and costs were similar between groups.

CONCLUSION

Dasatinib dose modification after pleural effusion was not always required; however, patients with dose modifications continued therapy for a longer duration with a lower rate of switching to another TKI versus patients who remained on a stable dose.

摘要

简介

达沙替尼治疗慢性髓性白血病(CML)与胸腔积液的发生有关;然而,关于其最佳管理的数据有限。我们检查了胸腔积液发生后接受达沙替尼治疗的 CML 患者的治疗模式、医疗资源利用(HCRU)和成本。

方法

使用来自索赔数据库的数据,确定了 2015-2018 年接受达沙替尼治疗且至少有 1 次达沙替尼用药索赔的 CML 成人患者,这些患者在接受达沙替尼治疗后出现胸腔积液。

结果

共有 123 名患者符合条件。在接受剂量调整的患者中,有 38.2%的患者在 1 年后进行了剂量调整,其中 72.3%的患者没有更换治疗方案;在这些患者中,有 70.6%的患者继续接受治疗。在胸腔积液后剂量稳定的患者中(61.8%),有 57.9%的患者后来改用另一种 TKI。与剂量稳定的患者相比,胸腔积液后达沙替尼治疗的平均(SD)持续时间在剂量调整的患者中为 262.0(124.0)天,而在剂量稳定的患者中为 149.1(155.2)天(p < 0.001)。两组之间的 HCRU 和成本相似。

结论

胸腔积液后达沙替尼剂量调整并非总是必需的;然而,与剂量稳定的患者相比,剂量调整的患者继续治疗的时间更长,而改用另一种 TKI 的患者比例较低。

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