Dosing Patterns and Transfusion Use in Cancer Patients Treated with Erythropoietic Agents: Results of an Observational Study of over 8,000 Patients.
Notice bibliographique
Résumé
Abstract Background: Epoetin alfa (EPO) and darbepoetin alfa (DARB) are FDA approved for the treatment of chemotherapy-related anemia in patients with non-myeloid malignancies. To understand current utilization patterns, this retrospective study examined real-world EPO and DARB treatment patterns (administration frequency, dosing, and treatment duration), frequency of physician visits, and red blood cell (RBC) transfusion use in adult patients with cancer. Methods: An analysis of medical claims from July 2002 through February 2005 using the Integrated Health Care Information services (IHCIS) national database, which encompasses over 35 health plans, was conducted. Patients included in the study were ≥ 18 years old, had ≥ 1 claim for cancer within 90 days prior to treatment initiation, were newly initiated on EPO or DARB, and received ≥ 2 treatment doses. Patient dosing frequency was classified into three mutually exclusive categories: (a) once weekly (QW; ≤ 9 days), (b) once every other week (Q2W; 9.1 to 18 days), and (c) once every three weeks or longer (≥ Q3W; >18 days), based on the average dosing interval during treatment. Dose only ratio (Units EPO: mcg DARB) was calculated using the ratio of cumulative dose of erythropoietic agents. Frequencies of outpatient hematologist and/or oncologist visits were summarized for EPO and DARB patients. RBC transfusions were identified using the medical procedure codes and the proportion of patients transfused was compared between the two groups. Results: 5,796 EPO and 2,226 DARB patients met inclusion criteria. Patients receiving EPO were slightly older (59.1 vs. 57.5 years, P<.001) with a lower proportion of female patients (62% vs. 67%, P<.001), compared to those patients receiving DARB. Variability of administration frequency was observed in both treatment groups (EPO: QW 53%, Q2W 38%, ≥ Q3W 9%; DARB: QW 11%, Q2W 67%, ≥ Q3W 22%). Mean treatment duration was similar for both groups (EPO: 58 days; DARB: 59 days; p=0.339). The mean cumulative dose was 269,811 Units for the EPO group and 1,154 mcg for the DARB group, corresponding to a dose only ratio of 234:1 (Units EPO: mcg DARB). While the majority of patients received fixed dosing of EPO 40,000 Units and DARB 200 mcg, extended dosing intervals (≥ Q2W) observed with both agents resulted in a mean weekly EPO dose of 29,281 Units and mean weekly DARB dose of 114 mcg. Frequencies of outpatient hematologist or oncologist visits during treatment were similar between the two groups (visits: 7.7 for EPO vs. 7.5 for DARB, P=0.462). Finally, RBC transfusion was administered to 6.9% of EPO patients compared to 8.4% of DARB patients (p=0.023). Conclusion: The treatment patterns and dose only ratio from the current study provide greater understanding of the relative effectiveness of these two erythropoietic agents. This observational study of over 8,000 patients shows that the dose only ratio from EPO to DARB is 234:1, frequencies of outpatient hematologist or oncologist visits are similar across the two groups, and transfusion rate is significantly lower in patients treated with EPO, compared to patients treated with DARB. These findings confirm similar results from past research.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».