Survival impact of adherence to tyrosine kinase inhibitor in chronic myeloid leukemia

Background/Aims Adherence to tyrosine kinase inhibitors (TKIs) has become a critical aspect of care in chronic myeloid leukemia (CML). We aimed to examine the association of TKI adherence with overall survival (OS) outcomes in Korean patients diagnosed with CML and treated with TKIs using data from...

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Autores principales:	Yundeok Kim, Tae-Hwa Go, Jaeyeon Jang, Jii Bum Lee, Seung Taek Lim, Kwang Yong Shim, Jong In Lee, Jee Hyun Kong
Formato:	article
Lenguaje:	EN
Publicado:	The Korean Association of Internal Medicine 2021
Materias:	chronic myeloid leukemia tyrosine kinase inhibitor medication possession ratio adherence Medicine R
Acceso en línea:	https://doaj.org/article/a1650ede77cf4f2bb35f4fb69c3c8a46
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spelling	oai:doaj.org-article:a1650ede77cf4f2bb35f4fb69c3c8a462021-11-08T00:59:06ZSurvival impact of adherence to tyrosine kinase inhibitor in chronic myeloid leukemia1226-33032005-664810.3904/kjim.2021.158https://doaj.org/article/a1650ede77cf4f2bb35f4fb69c3c8a462021-11-01T00:00:00Zhttp://www.kjim.org/upload/pdf/kjim-2021-158.pdfhttps://doaj.org/toc/1226-3303https://doaj.org/toc/2005-6648Background/Aims Adherence to tyrosine kinase inhibitors (TKIs) has become a critical aspect of care in chronic myeloid leukemia (CML). We aimed to examine the association of TKI adherence with overall survival (OS) outcomes in Korean patients diagnosed with CML and treated with TKIs using data from the National Health Information Database. Methods This study included 2,870 CML patients diagnosed between 2005 and 2013. Drug adherence was evaluated according to the medication possession ratio (MPR) and classified as high adherence (i.e., MPR ≥ 0.95 [upper 50%]), moderate adherence (i.e., MPR ≥ 0.68 and < 0.95 [middle 25%]), and low adherence (i.e., MPR < 0.68 [lower 25%]). Results The median MPR was 0.95 (range, 0 to 4.67). Male sex (p = 0.003), age < 70 years (p < 0.001), high income (≥ 30%, p < 0.001), and maintaining frontline TKI (< 0.001) were associated with better adherence. Adherence to dasatinib was the lowest (vs. imatinib or nilotinib, p < 0.001). Compared with high MPR patients, those with moderate MPR (hazard ratio [HR], 4.90; 95% confidence interval [CI], 3.87 to 6.19; p < 0.001) and low MPR (HR, 11.6; 95% CI, 9.35 to 14.42; p < 0.001) had poorer OS. Conclusions Adherence to TKI treatment is an important factor predicting survival outcomes in Korean CML patients. Male sex, age < 70 years, high income, and maintaining frontline TKI are associated with high adherence to TKI. Thus, those without these characteristics should be closely monitored for treatment adherence.Yundeok KimTae-Hwa GoJaeyeon JangJii Bum LeeSeung Taek LimKwang Yong ShimJong In LeeJee Hyun KongThe Korean Association of Internal Medicinearticlechronic myeloid leukemiatyrosine kinase inhibitormedication possession ratioadherenceMedicineRENThe Korean Journal of Internal Medicine, Vol 36, Iss 6, Pp 1450-1458 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	chronic myeloid leukemia tyrosine kinase inhibitor medication possession ratio adherence Medicine R
spellingShingle	chronic myeloid leukemia tyrosine kinase inhibitor medication possession ratio adherence Medicine R Yundeok Kim Tae-Hwa Go Jaeyeon Jang Jii Bum Lee Seung Taek Lim Kwang Yong Shim Jong In Lee Jee Hyun Kong Survival impact of adherence to tyrosine kinase inhibitor in chronic myeloid leukemia
description	Background/Aims Adherence to tyrosine kinase inhibitors (TKIs) has become a critical aspect of care in chronic myeloid leukemia (CML). We aimed to examine the association of TKI adherence with overall survival (OS) outcomes in Korean patients diagnosed with CML and treated with TKIs using data from the National Health Information Database. Methods This study included 2,870 CML patients diagnosed between 2005 and 2013. Drug adherence was evaluated according to the medication possession ratio (MPR) and classified as high adherence (i.e., MPR ≥ 0.95 [upper 50%]), moderate adherence (i.e., MPR ≥ 0.68 and < 0.95 [middle 25%]), and low adherence (i.e., MPR < 0.68 [lower 25%]). Results The median MPR was 0.95 (range, 0 to 4.67). Male sex (p = 0.003), age < 70 years (p < 0.001), high income (≥ 30%, p < 0.001), and maintaining frontline TKI (< 0.001) were associated with better adherence. Adherence to dasatinib was the lowest (vs. imatinib or nilotinib, p < 0.001). Compared with high MPR patients, those with moderate MPR (hazard ratio [HR], 4.90; 95% confidence interval [CI], 3.87 to 6.19; p < 0.001) and low MPR (HR, 11.6; 95% CI, 9.35 to 14.42; p < 0.001) had poorer OS. Conclusions Adherence to TKI treatment is an important factor predicting survival outcomes in Korean CML patients. Male sex, age < 70 years, high income, and maintaining frontline TKI are associated with high adherence to TKI. Thus, those without these characteristics should be closely monitored for treatment adherence.
format	article
author	Yundeok Kim Tae-Hwa Go Jaeyeon Jang Jii Bum Lee Seung Taek Lim Kwang Yong Shim Jong In Lee Jee Hyun Kong
author_facet	Yundeok Kim Tae-Hwa Go Jaeyeon Jang Jii Bum Lee Seung Taek Lim Kwang Yong Shim Jong In Lee Jee Hyun Kong
author_sort	Yundeok Kim
title	Survival impact of adherence to tyrosine kinase inhibitor in chronic myeloid leukemia
title_short	Survival impact of adherence to tyrosine kinase inhibitor in chronic myeloid leukemia
title_full	Survival impact of adherence to tyrosine kinase inhibitor in chronic myeloid leukemia
title_fullStr	Survival impact of adherence to tyrosine kinase inhibitor in chronic myeloid leukemia
title_full_unstemmed	Survival impact of adherence to tyrosine kinase inhibitor in chronic myeloid leukemia
title_sort	survival impact of adherence to tyrosine kinase inhibitor in chronic myeloid leukemia
publisher	The Korean Association of Internal Medicine
publishDate	2021
url	https://doaj.org/article/a1650ede77cf4f2bb35f4fb69c3c8a46
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Survival impact of adherence to tyrosine kinase inhibitor in chronic myeloid leukemia

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