Incidence, Prevalence, and Real-World Treatment Patterns in Chronic Myeloid Leukemia: Results from a Population-Representative German Claims Data Analysis

Abstract

<b><i>Introduction:</i></b> Real-world data on usage of 1st-, 2nd-, and 3rd-generation tyrosine kinase inhibitor (TKI) in chronic myeloid leukemia (CML) are scarce. This study therefore aimed to analyze the use of different TKIs used in 1st- and 2nd-line treatment and the frequency of TKI switches in CML. <b><i>Methods:</i></b> This observational study was based on the InGef research database, an anonymized representative claims dataset in Germany (<i>n</i> = 4 million). An incidence and prevalence patient CML cohort was followed for 5 and 3 years. Analyses regarding incidence, prevalence, and therapy distribution were performed descriptively. <b><i>Results:</i></b> 151 patients were included in the incidence and 636 patients in the prevalence cohort. This resulted in an incidence of 1.8 (95% confidence interval [CI]: 1.34–2.20) and a prevalence of 14.9 (95% CI: 13.70–16.03) per 100,000 inhabitants. For the incidence cohort, data on 1st-line therapy were available for 124 patients and distributed across imatinib (<i>N</i> = 52), nilotinib (<i>N</i> = 44), dasatinib (<i>N</i> = 12), chemotherapies as hydroxycarbamide (<i>N</i> = 11), and ponatinib/bosutinib (<i>N</i> = 5). Twenty-six percent of patients switched TKI therapy at least once in 3 years. In the prevalence cohort, 423 patients (66.5%) had claims on existing or newly emerged cardiovascular diseases (CDs). No significant differences (<i>p</i> = 0.32) between TKIs in patients with CD were found. <b><i>Discussion:</i></b> Every fourth patient switched TKI therapy within the first 3 years after treatment initiation. Switches were more likely when hints of disease progression or intolerability were observable in the database.