Evaluation of Real-world treatment patterns in Japanese patients with cGVHD: A retrospective claims database study

Area of Science:

• Hematology
• Immunology
• Pharmacology

Background:

• Chronic graft-versus-host disease (cGVHD) is a significant complication following allogeneic stem cell transplantation.
• Steroid-refractory cGVHD often requires subsequent lines of therapy.
• Understanding real-world treatment patterns and outcomes is crucial for optimizing cGVHD management.

Purpose of the Study:

• To evaluate the duration of treatment (DoT) and steroid dose reduction in adult patients with cGVHD receiving second- or later-line therapy with mycophenolate mofetil (MMF), ibrutinib, or ruxolitinib.
• To provide insights into the real-world utilization of these therapies in Japan.

Main Methods:

• Retrospective cohort study utilizing the Medical Data Vision (MDV) database.
• Included adult patients diagnosed with cGVHD between 2003 and 2023, who received steroids prior to diagnosis and MMF, ibrutinib, or ruxolitinib as second- or later-line therapy.
• Assessed DoT and steroid dose reduction during second-line therapy.

Main Results:

• Of 854 included patients, 226 had data on second- or later-line treatments.
• The most common second-line therapies were MMF (48.67%), followed by ibrutinib (38.94%) and ruxolitinib (12.39%).
• Median DoT was 95 days for MMF, 86 days for ibrutinib, and 30 days for ruxolitinib. Steroid doses were generally maintained below 0.5 mg/kg/day.

Conclusions:

• MMF demonstrated the longest median duration of treatment among the evaluated second-line therapies for cGVHD in this Japanese real-world cohort.
• Ibrutinib and ruxolitinib were also utilized, with varying treatment durations.
• These findings contribute to understanding current cGVHD treatment strategies in Japan.