Introduction: Treatment with dasatinib for chronic myeloid leukemia (CML) has been associated with development of pleural effusion, however data regarding its optimal management are limited. We examined treatment patterns and healthcare resource utilization (HCRU) and costs among patients with CML treated with dasatinib who experienced a subsequent pleural effusion. Methods: Adults with CML and ≥1 pharmacy claim for dasatinib in 2015–2018 who experienced pleural effusion after dasatinib were identified using data from claims databases. Results: Overall, 123 patients were eligible. After 1 year, of the 38.2% of patients with a dose modification, 72.3% did not switch treatment; amongst these patients, 70.6% continued treatment. Among patients with a stable dose after pleural effusion (61.8%), 57.9% later switched to another TKI. The mean (SD) duration of dasatinib treatment after pleural effusion was 262.0 (124.0) days for patients with a dose modification versus 149.1 (155.2) days for those with a stable dose (p < 0.001). HCRU and costs were similar between groups. Discussion/Conclusion: Dasatinib dose modification after pleural effusion was not always required; however, patients with dose modifications continued therapy for a longer duration with a lower rate of switching to another TKI versus patients who remained on a stable dose.


中文翻译：

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慢性粒细胞白血病达沙替尼治疗期间出现胸腔积液的达沙替尼治疗模式分析

简介：达沙替尼治疗慢性粒细胞白血病 (CML) 与胸腔积液的发生有关，但有关其最佳治疗的数据有限。我们检查了接受达沙替尼治疗且随后出现胸腔积液的 CML 患者的治疗模式、医疗资源利用率 (HCRU) 和费用。方法：使用索赔数据库中的数据来识别 2015 年至 2018 年患有 CML 且达沙替尼治疗后出现胸腔积液的≥1 次药房索赔的成人。结果：总体而言，123 名患者符合条件。1 年后，38.2% 的患者进行了剂量调整，其中 72.3% 没有改变治疗；在这些患者中，70.6%继续接受治疗。胸腔积液后剂量稳定的患者（61.8%）中，57.9%后来改用另一种 TKI。胸腔积液后达沙替尼治疗的平均 (SD) 持续时间对于剂量调整的患者为 262.0 (124.0) 天，而对于稳定剂量的患者为 149.1 (155.2) 天 (p < 0.001)。各组之间的 HCRU 和费用相似。讨论/结论：胸腔积液后并不总是需要调整达沙替尼剂量；然而，与保持稳定剂量的患者相比，进行剂量调整的患者继续治疗的时间更长，转用另一种 TKI 的比率较低。