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German Population–Based Study Offers Insight Into Use of TKIs for CML

By: Joseph Fanelli
Posted: Thursday, September 5, 2019

According to a German population–based study of patients diagnosed with Philadelphia chromosome–positive chronic myeloid leukemia (CML) presented in the European Journal of Haematology, almost one-third of patients, particularly elderly patients, do not receive the recommended daily doses of tyrosine kinase inhibitors (TKIs). However, molecular monitoring was performed regularly in the majority of patients in all age groups, observed Verena S. Hoffmann, PhD, of Ludwig Maximillian University, Munich, and colleagues.

“It is alarming that even in the most prosperous part of a highly developed country with an extensive statutory health insurance system, still a considerable number of patients did not receive the adequate treatment for a potentially fatal disease,” the authors concluded.

The investigators used data from the Bavarian Association of Statutory Health Insurance Physicians, which include claim information from 10.5 million people in the region. The authors analyzed patient data from 2010 to 2016 and included patients with at least two recordings of CML and CML-related treatment in two separate quarters. In total, 1,714 patients were observed.

Dr. Hoffmann and colleagues found that 50.8% of the patients included in the study received more than 67.5 daily doses of TKIs each quarter year and that 18.2% of the patients did not receive any TKIs. Among men, the mean number of daily doses was at least 80 doses per quarter year for all age groups, but this number decreased to 62 doses among elderly women (aged 65 and older). That was the only noted difference in dosage rates between men and women. Across the board, the percentage of patients who did not receive TKIs appeared to increase with the patient’s age.

“Patients and physicians need to be motivated to take more care for using the required daily dosages,” the authors noted. “As data indicate, this may even be cost‐effective, as poor adherence with TKI treatment results in higher health-care costs.”

Disclosure: The study authors reported no conflicts of interest.



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