PMID- 32399812
OWN - NLM
STAT- MEDLINE
DCOM- 20210215
LR  - 20210215
IS  - 1865-8652 (Electronic)
IS  - 0741-238X (Linking)
VI  - 37
IP  - 7
DP  - 2020 Jul
TI  - Real-World Treatment Patterns, Adverse Events, Resource Use, and Costs Among 
      Commercially Insured, Younger Patients with Chronic Lymphocytic Leukemia in the 
      USA: A Retrospective Cohort Study.
PG  - 3129-3148
LID - 10.1007/s12325-020-01350-w [doi]
AB  - INTRODUCTION: Amidst a changing treatment landscape, real-world evidence on the 
      burden of chronic lymphocytic leukemia (CLL) is limited. The purpose of this 
      study was to describe treatment patterns, adverse events (AEs), and economic 
      burden among treated patients with CLL. METHODS: A retrospective cohort study was 
      conducted with IQVIA PharMetrics((R)) Plus. Patients at least 18 years old with CLL 
      treatment between November 1, 2013 and May 31, 2018 were identified; index date 
      was first observed CLL treatment. Patients had at least one CLL diagnosis 
      pre-index and a second diagnosis anytime during the study period, at least 1-year 
      pre- and at least 30-day post-index continuous enrollment and no pre-index CLL 
      treatment. Analyses focused on patients receiving one of the four most common 
      regimens observed. Outcomes included treatment patterns, frequency of incident 
      AEs, and healthcare resource use and costs. Multivariable logistic regression and 
      generalized linear modelling were used to evaluate risk of hospitalization and 
      all-cause costs per patient per month (PPPM). RESULTS: A total of 1706 patients 
      were included in the study (median [interquartile range] age 58 [55-62] years, 
      66% male, median Charlson Comorbidity Index 2 [2-3], median follow-up 16 
      [8-28] months). Common regimens, irrespective of treatment line, were 
      bendamustine-rituximab (B-R, 27%), ibrutinib monotherapy (I, 27%), rituximab 
      monotherapy (R, 19%), and fludarabine combined with cyclophosphamide and 
      rituximab (FCR, 16%); 59% had at least one incident AE (B-R, 62%; I, 60%; R, 25%; 
      FCR, 79%). Mean total all-cause healthcare cost over follow-up was 
      $13,858 +/- 14,626 PPPM. Increased number of AEs was associated with increased odds 
      of hospitalization (odds ratio = 2.9; 95% confidence interval [CI] 2.5-3.4) and 
      increased mean cost PPPM (cost ratio = 1.2; 95% CI 1.1-1.2). CONCLUSION: This 
      study highlights the treatment toxicity and associated economic burden among 
      patients with CLL in the USA. As novel therapies are increasingly used, further 
      research examining outcomes will inform the risks, benefits, and value of novel 
      agents to prescribers and patients.
FAU - Kabadi, Shaum M
AU  - Kabadi SM
AD  - AstraZeneca, Gaithersburg, MD, USA.
FAU - Near, Aimee
AU  - Near A
AD  - IQVIA, Falls Church, VA, USA.
FAU - Wada, Keiko
AU  - Wada K
AD  - IQVIA, Falls Church, VA, USA. Keiko.wada@iqvia.com.
FAU - Burudpakdee, Chakkarin
AU  - Burudpakdee C
AD  - IQVIA, Falls Church, VA, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200512
PL  - United States
TA  - Adv Ther
JT  - Advances in therapy
JID - 8611864
RN  - 0 (Piperidines)
RN  - 1X70OSD4VX (ibrutinib)
RN  - 4F4X42SYQ6 (Rituximab)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - FA2DM6879K (Vidarabine)
RN  - JAC85A2161 (Adenine)
EIN - Adv Ther. 2020 Jun 13;:. PMID: 32535853
MH  - Adenine/analogs & derivatives/economics/therapeutic use
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Combined Chemotherapy Protocols/*adverse 
      effects/*economics/*therapeutic use
MH  - Cohort Studies
MH  - Cyclophosphamide/economics/therapeutic use
MH  - Female
MH  - Health Care Costs/*statistics & numerical data
MH  - Humans
MH  - Leukemia, Lymphocytic, Chronic, B-Cell/*drug therapy/*economics/*epidemiology
MH  - Male
MH  - Middle Aged
MH  - Piperidines/economics/therapeutic use
MH  - Retrospective Studies
MH  - Rituximab/economics/therapeutic use
MH  - United States/epidemiology
MH  - Vidarabine/economics/therapeutic use
MH  - Young Adult
OTO - NOTNLM
OT  - Adverse events
OT  - Chronic lymphocytic leukemia
OT  - Costs
OT  - Healthcare resource use
OT  - Real world
OT  - Treatment patterns
EDAT- 2020/05/14 06:00
MHDA- 2021/02/16 06:00
CRDT- 2020/05/14 06:00
PHST- 2020/03/03 00:00 [received]
PHST- 2020/05/14 06:00 [pubmed]
PHST- 2021/02/16 06:00 [medline]
PHST- 2020/05/14 06:00 [entrez]
AID - 10.1007/s12325-020-01350-w [pii]
AID - 10.1007/s12325-020-01350-w [doi]
PST - ppublish
SO  - Adv Ther. 2020 Jul;37(7):3129-3148. doi: 10.1007/s12325-020-01350-w. Epub 2020 
      May 12.