Bristol Myers Squibb, Princeton, New Jersey, USA.
PHAR (Partnership for Health Analytic Research), LLC, Beverly Hills, California, USA.
Acta Haematol. 2023;146(4):259-266. doi: 10.1159/000530512. Epub 2023 Apr 10.
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.
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.
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.
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.
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。
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。
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。
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。
