比利时慢性髓性白血病患者的伊马替尼布坚持和持续性:来自现实世界的数据的证据
Sandra Michiels1,2,3, Sandra Tricas-Sauras2, Adriano Salaroli3
1Center for Research in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.
Patient preference and adherence
|September 30, 2024
概括
在比利时的慢性髓性白血病 (CML) 患者中,意马替尼的坚持率非常低,并且随着时间的推移而下降. 年轻的年龄和较少的并发症预测了更好的坚持,这对治疗成功至关重要.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 伊马替尼的坚持和持续性对于有效的慢性髓性白血病 (CML) 治疗至关重要.
- 之前没有比利时国家研究评估了这些患者的行为.
- 了解坚持预测因素对于优化CML管理至关重要.
研究的目的:
- 在比利时进行首次全国性对伊马替尼的坚持和持久性的评估.
- 为了识别与伊马替尼布坚持相关的基于药房的预测因素.
- 评估守对CML患者死亡率和移植率的影响.
主要方法:
- 对1194名比利时CML患者进行了回顾性队列研究,这些患者接受了imaatinib治疗 (2004-2016).
- 通过24个月内所覆盖日数比例 (PDC) 衡量依从性.
- 根据停药的时间 (≥90天间隔) 评估的持续性.
- 多变量Poisson和Cox回归模型用于识别与坚持和持久性相关的预测因素和因素.
主要成果:
- 六个月的坚持率为60.3%,在24个月后降至30.1%.
- 年轻的年龄和缺乏并发症与更高的坚持有关.
- 中位持续时间为334.5天;24个月持续时间为83.6%.
- 年龄较大 (≥75岁) 显著增加停止治疗的风险.
- 在不坚持的患者中观察到更高的移植和死亡率.
结论:
- 在比利时,在全国范围内观察到依赖意马替尼的坚持度急剧下降,这取决于时间.
- 基于药房的预测因素,如年龄和并发症状况,可以识别有风险的患者.
- 需要针对这些预测因素的干预措施来改善CML治疗结果.
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