Treatment Patterns in Chronic Graft-Versus-Host Disease (cGVHD) Patients in China: A Real-World Retrospective Analysis

Speaker(s)

Wang L1, Zhang Y2, Shi F3, Tong S4, Gallardo AP5, Sun W5, Chen P1
1China Pharmaceutical University, Nanjing, Jiangsu, China, 2School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China, 3International Research Center for Medicinal Administration Peking Univerisity, beijing, 11, China, 4The National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, Beijing, China, 5Beijing Intelligent Decision Medical Technology Co., Ltd, Beijing, Beijing, China

Presentation Documents

OBJECTIVES: This study aims to evaluate the real-world treatment patterns among Chinese cGVHD patients by reporting medications used and treatment duration within different treatment sequences.

METHODS: Patients initiated systemic treatments for cGVHD after allogeneic Hematopoietic Stem Cell Transplantation (allo-HSCT) from 1 January 2016 to 1 January 2023 were identified from a regional electronic health record database in China. Patients above 12 years old with at least 1-year follow-up post-treatment were included. The first-line treatment was defined as the initial systemic therapy post-HSCT, change of the treatment sequences was define as initiation of one or more systematic treatments. Durations of treatments were defined as time to discontinuation.

RESULTS: A total of 1,849 cGVHD patients were included. The mean age was 35.2±9.5 years with 12 to 18 year-old-patients accounting for 6.0%. The percentage of males was 52.8%. Among the 90.3% patients receiving first-line treatment, corticosteroids (100%) with median treatment duration of 4.7 months was the most common therapies followed by calcineurin inhibitor (CNIs, 19%). A number of 1,348 patients (80.8%) received second-line or subsequent treatments with a median treatment duration of 5.1 (95% CI:4.6-6.0) months. Medications prescribed for the patients and the respective percentages included Mycophenolate mofetil (MMF, 57.2%), Ruxolitinib (50.4%), Methotrexate (MTX, 36.4%), mesenchymal stem cells (MSC, 29.8%), Sirolimus (13.4%), Rituximab (8.6%), Thalidomide (6.6%), Imatinib (4.2%), and Ibrutinib (1.1%). The median treatment durations are 4.6 (95%CI 3.0-6.0) months, 8.0 (95%CI: 4.6-14) months and 4.7 (95%CI: 4.1-5.8) months for MMF, Ruxolitinib and MTX, respectively. A number of 824 patients received third-line or subsequent treatments with a median treatment of 4.57 months. Ruxolitinib (38.4%) was the most common prescription.

CONCLUSIONS: Chinese cGVHD patients exhibit diverse treatment patterns with high medication switch rates and relatively short treatment durations. Therefore, personalized treatment strategies and studies exploring cost-effectiveness for different treatment sequences are required.

Code

RWD142

Topic

Study Approaches

Topic Subcategory

Electronic Medical & Health Records

Disease

No Additional Disease & Conditions/Specialized Treatment Areas, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)