Prescribing Characteristics of Octreotide Immediate-Release and Long-Acting Release in Patients with Neuroendocrine Tumors.

Autor:	Cheng Y; Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, USA.; Institute of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Kentucky, Lexington, KY, USA., Anthony L; Department of Internal Medicine, Division of Medical Oncology, Markey Cancer Center, University of Kentucky, Lexington, KY, USA., Delcher C; Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, USA.; Institute of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Kentucky, Lexington, KY, USA., Moga DC; Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, USA.; Institute of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Kentucky, Lexington, KY, USA.; Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA.; Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA., Chauhan A; Department of Internal Medicine, Division of Medical Oncology, Markey Cancer Center, University of Kentucky, Lexington, KY, USA., Huang B; Division of Cancer Biostatistics, Department of Internal Medicine, College of Medicine, University of Kentucky, Lexington, KY, USA., Adams V; Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, USA.; Institute of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Kentucky, Lexington, KY, USA.; Department of Internal Medicine, Division of Medical Oncology, Markey Cancer Center, University of Kentucky, Lexington, KY, USA.
Jazyk:	angličtina
Zdroj:	The oncologist [Oncologist] 2023 Jun 02; Vol. 28 (6), pp. 479-485.
DOI:	10.1093/oncolo/oyad057
Abstrakt:	Background: Treatment recommendations for patients with neuroendocrine tumors (NETs) include the use of octreotide long-acting release (LAR) for long-term therapy and immediate-release (IR) as rescue therapy to control the breakthrough symptoms of carcinoid syndrome (CS). High doses of LAR are commonly used in clinical practice. This study aimed to evaluate the real-world utilization of LAR and preceding IR use at the prescription and patient levels. Methods: We used an administrative claims database (2009-2018) containing privately insured enrollees. We calculated the normalized LAR dose from pharmacy claims and the initial mean IR daily dose at the prescription level. At the patient level, we conducted a retrospective cohort study that included patients continuously enrolled with ≥1 pharmacy claim of LAR and evaluated the frequency and the clinical reason for dose escalation of LAR. The definition of the above-label maximum dose of LAR was ≥30 mg/4 weeks. Results: Nineteen percent of LAR prescriptions had an above-label maximum dose. Only 7% of LAR prescriptions had preceding IR use. There were 386 patients with NETs or CS vs. 570 with an unknown diagnosis. Comparing patients with NETs or CS to those with an unknown diagnosis, 22.3% vs. 11.0 % experienced dose escalations and 29.0% vs. 26.6% had IR use before dose escalation, respectively. LAR dose escalation occurred in 50.9% vs. 39.2% for symptom control, 12.3% vs. 7.1% for tumor progression control, and 16.6% vs. 6.0% for both reasons in NETs/CS and unknown groups, respectively. Conclusion: Octreotide LAR dosing above the label-maximum dose is common and IR rescue dosing appears to be underutilized. (© The Author(s) 2023. Published by Oxford University Press.)
Databáze:	MEDLINE
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