Impact of Adherence to Ibrutinib on Clinical Outcomes in Real-World Patients With Chronic Lymphocytic Leukemia.

Autor:	Garner LM; University of North Carolina Medical Center, Chapel Hill, North Carolina., Kline T; University of North Carolina Medical Center, Chapel Hill, North Carolina., Miller J; University of North Carolina Medical Center, Chapel Hill, North Carolina., Deal A; University of North Carolina Medical Center, Chapel Hill, North Carolina., Zhu A; University of North Carolina Medical Center, Chapel Hill, North Carolina., Sketch MR; University of North Carolina Medical Center, Chapel Hill, North Carolina., Coombs CC; University of North Carolina Medical Center, Chapel Hill, North Carolina., Muluneh B; University of North Carolina Medical Center, Chapel Hill, North Carolina.
Jazyk:	angličtina
Zdroj:	Journal of the advanced practitioner in oncology [J Adv Pract Oncol] 2021 Jan-Feb; Vol. 12 (1), pp. 20-28. Date of Electronic Publication: 2021 Jan 01.
DOI:	10.6004/jadpro.2021.12.1.2
Abstrakt:	Background: Chronic lymphocytic leukemia (CLL) is a B-cell neoplasm with clonal expansion of small lymphocytes. Ibrutinib, an irreversible inhibitor of Bruton tyrosine kinase (BTK), is a first-line treatment option, and recent data suggest that strict adherence is directly related to clinical outcomes. Objectives: The primary objective of this study was to quantify ibrutinib adherence rates in real-world patients with CLL on ibrutinib; secondary outcomes included progression-free survival and overall survival. Methods: This retrospective study included subjects who were treated at a large academic medical center over approximately 5 years. Subjects were at least 18 years, diagnosed with CLL or small lymphocytic lymphoma, and treated with ibrutinib monotherapy for at least 6 months. Adherence was quantified using the medication possession ratio (MPR), which is the ratio of the sum of days' supply of medication in a period over the number of days in that period, and was based on fill history from the medical center's specialty pharmacy. Results: For the 32 subjects in this study, the mean ibrutinib adherence rate was 91.7% (range, 84.4%-100%). Only 3 subjects had disease progression, and 1 death was recorded while on therapy (all with MPR < 95%); therefore, analyses of clinical outcomes were unable to be assessed due to a low number of events. There were no statistically significant differences in rates of adherence based on baseline characteristics and adverse drug events. Conclusion: In patients with CLL treated with ibrutinib, mean adherence was 91.7%, which is lower than rates seen in clinical trials. Competing Interests: Dr. Coombs has received honoraria from AbbVie, Loxo, Pharmacyclics, Octapharma, and H3 Biomedicine, has served as a consultant for AbbVie, Covance, and Cowen & Co., and has received institutional funding from Incyte, Gilead, AROG, Loxo, and H3 Biomedicine. The remaining authors have no conflicts of interest to disclose. (© 2021 Harborside™.)
Databáze:	MEDLINE
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