| Autor: |
Huntington SF; Department of Internal Medicine, Section of Hematology, Yale University School of Medicine, New Haven, CT, USA., de Nigris E; Merck & Co., Inc., Rahway, NJ, USA., Puckett J; COVIA Health Solutions, Lansdale, PA, USA., Kamal-Bahl S; COVIA Health Solutions, Lansdale, PA, USA., Farooqui M; Merck & Co., Inc., Rahway, NJ, USA., Ryland K; Merck & Co., Inc., Rahway, NJ, USA., Sarpong E; Merck & Co., Inc., Rahway, NJ, USA., Leng S; Merck & Co., Inc., Rahway, NJ, USA., Yang X; Merck & Co., Inc., Rahway, NJ, USA., Doshi JA; Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. |
| Abstrakt: |
Prior studies evaluating ibrutinib discontinuation are limited to clinical trials and selected medical centers and hence may not reflect real-world practice. This study used Medicare claims (2013-2019) to examine ibrutinib discontinuation and associated factors among elderly patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL). Over a median follow-up of 2.1 years, two-thirds (65.2%) of the 11,870 new ibrutinib initiators were discontinued, with half (45.1%) of patients discontinuing within 12 months of initiation. Factors such as advanced age, lack of Part D low-income subsidy, evidence of prior CLL/SLL treatment, and cardiovascular comorbidities (e.g. atrial fibrillation) were associated with higher risk of discontinuation. Over a median of 1.2 years from discontinuation, 40% of discontinuers initiated another CLL/SLL treatment after ibrutinib discontinuation; 25% of patients restarted ibrutinib treatment at some point over follow-up. Our findings point to a large unmet need with the widely used BTKi ibrutinib and underscore the importance of ongoing development of efficacious and well-tolerated CLL/SLL therapies. |
