PMID- 32054500
OWN - NLM
STAT- MEDLINE
DCOM- 20210618
LR  - 20210618
IS  - 1750-1172 (Electronic)
IS  - 1750-1172 (Linking)
VI  - 15
IP  - 1
DP  - 2020 Feb 13
TI  - Adverse event rates and economic burden associated with purine nucleoside analogs 
      in patients with hairy cell leukemia: a US population-retrospective claims 
      analysis.
PG  - 47
LID - 10.1186/s13023-020-1325-9 [doi]
LID - 47
AB  - BACKGROUND: Purine nucleoside analogs (PNAs) are the recommended first-line 
      treatment for patients with hairy cell leukemia (HCL), but they are associated 
      with adverse events (AEs). Due to a lack of real-world evidence regarding AEs 
      that are associated with PNAs, we used commercial data to assess AE rates, 
      AE-related health care resource utilization (HCRU), and costs among PNA-treated 
      patients with HCL. Adults aged >/=18 years with >/=2 claims for HCL >/=30 days apart 
      from 1 January 2006 through 31 December 2015 were included. Included patients had 
      >/=1 claim for HCL therapy (cladribine +/- rituximab or pentostatin +/- rituximab 
      [index date: first claim date]) and continuous enrollment for a >/= 6-month 
      baseline and >/= 12-month follow-up period. Patient sub-cohorts were based on the 
      occurrence of myelosuppression and opportunistic infections (OIs). Generalized 
      linear models were used to compare HCRU and costs. RESULTS: In total, 647 
      PNA-treated patients were identified (mean age: 57.1 years). Myelosuppression and 
      OI incidence were 461 and 42 per 1000 patient-years, respectively. Adjusted 
      results indicated that those with myelosuppression had higher rates of 
      hospitalization (47.4% vs 12.4%; P < .0001) and incurred higher mean inpatient 
      costs ($23,517 vs $12,729; P = .011) and total costs ($57,325 vs $34,733; 
      P = .001) as compared with those without myelosuppression. Similarly, patients 
      with OIs had higher rates of hospitalization (53.8% vs 30.8%; P = .025) and 
      incurred higher mean inpatient costs ($21,494 vs $11,229; P < .0001) as compared 
      with those without OIs. CONCLUSIONS: PNA therapy is highly effective but 
      associated with significant toxicities that increase costs; these findings 
      indicate a need for therapies with improved toxicity profiles and better risk 
      stratification of patients at risk of developing myelosuppression and OIs.
FAU - Epperla, Narendranath
AU  - Epperla N
AD  - Division of Hematology, The James Cancer Hospital and Solove Research Institute, 
      The Ohio State University Comprehensive Cancer Center, A346 Starling Loving Hall, 
      320W 10th Ave, Columbus, OH, 43210, USA. Narendranath.Epperla@osumc.edu.
FAU - Pavilack, Melissa
AU  - Pavilack M
AD  - AstraZeneca, Gaithersburg, MD, USA.
FAU - Olufade, Temitope
AU  - Olufade T
AD  - AstraZeneca, Gaithersburg, MD, USA.
FAU - Bashyal, Richa
AU  - Bashyal R
AD  - STATinMED Research, Plano, TX, USA.
FAU - Li, Jieni
AU  - Li J
AD  - STATinMED Research, Plano, TX, USA.
FAU - Kabadi, Shaum M
AU  - Kabadi SM
AD  - AstraZeneca, Gaithersburg, MD, USA.
FAU - Yuce, Huseyin
AU  - Yuce H
AD  - New York City College of Technology, New York, NY, USA.
FAU - Andritsos, Leslie
AU  - Andritsos L
AD  - Division of Hematology and Oncology, The University of New Mexico, Albuquerque, 
      NM, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200213
PL  - England
TA  - Orphanet J Rare Dis
JT  - Orphanet journal of rare diseases
JID - 101266602
RN  - 0 (Nucleosides)
RN  - 0 (Purine Nucleosides)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cost of Illness
MH  - Health Care Costs
MH  - Humans
MH  - Insurance Claim Review
MH  - *Leukemia, Hairy Cell/drug therapy
MH  - Middle Aged
MH  - Nucleosides
MH  - Purine Nucleosides
MH  - Retrospective Studies
PMC - PMC7020358
OTO - NOTNLM
OT  - Adverse events
OT  - Hairy cell leukemia
OT  - Myelosuppression
OT  - Purine nucleoside analogs
COIS- N Epperla, H Yuce, and L Andritsos have no conflicts to disclose. M Pavilack, T 
      Olufade, and S Kabadi are employees of AstraZeneca, the study sponsor. R Bashyal 
      and J Li are employees of STATinMED Research, a paid consultant to the study 
      sponsor.
EDAT- 2020/02/15 06:00
MHDA- 2021/06/22 06:00
PMCR- 2020/02/13
CRDT- 2020/02/15 06:00
PHST- 2019/10/31 00:00 [received]
PHST- 2020/01/28 00:00 [accepted]
PHST- 2020/02/15 06:00 [entrez]
PHST- 2020/02/15 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/02/13 00:00 [pmc-release]
AID - 10.1186/s13023-020-1325-9 [pii]
AID - 1325 [pii]
AID - 10.1186/s13023-020-1325-9 [doi]
PST - epublish
SO  - Orphanet J Rare Dis. 2020 Feb 13;15(1):47. doi: 10.1186/s13023-020-1325-9.