Chronic Myeloid Leukemia Coverage from Every Angle

Medication Adherence and Its Effect on Molecular Response in CML

By: Lauren Harrison, MS
Posted: Friday, August 7, 2020

Although nearly 25% of patients being treated with imatinib for chronic myeloid leukemia (CML) in a Malaysian study were nonadherent to their medication, it did not appear to have a significant effect on their chances of achieving a molecular responseZuraidah Mohd Yusoff, PhD, of the Universiti Saints Malaysia Gelugor, Penang, Malaysia, and colleagues published their findings regarding medication adherence in this patient population in the International Journal of Clinical Pharmacy. 

The study recruited 71 patients who had been diagnosed with CML and treated with either imatinib or nilotinib for more than 12 months. Participants were recruited from a hematology clinic in Malaysia, and medication adherence was determined via pharmacy notes and records from each patient. Researchers estimated an average medication possession ratio by dividing the sum of the supply days by the number of days until major molecular response achievement or days to the last refill. Patients were considered adherent if the ratio was above 90%.  

Approximately 40% of patients (n = 28achieved a major molecular response after 12 months of treatment, at a median of 15.5 months. Nearly 25% of patients receiving imatinib and 15% receiving nilotinib had less than 90% medication adherence. The median medication possession ratio for imatinib was 0.94, and the ratio for nilotinib was 0.96; however, this difference did not carry statistical significance. The lowest recorded medication possession ratio was 40%. No significant correlation was found between medication adherence and molecular response (odds ratio = 1.07, P = .911).  

Factors such as nausea and vomiting (odds ratio = 0.25) as well as disease phase at diagnosis (odds ratio = 0.20) both seemed to be associated with decreased patient adherence. In addition, patients who had accelerated-phase CML seemed less likely to be adherent to their treatment regimen (odds ratio = 0.20, P = .059). 

Disclosure: The authors reported no conflicts of interest. 

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