Presentation (CTI)

OBJECTIVES: Hematological Impact in Myelofibrosis in Emerging Markets (HellM) is a real-world study evaluating treatment patterns and health outcomes in patients with myelofibrosis (MF) in Argentina and Brazil. Here we evaluate trends in Janus kinase inhibitor (JAKi) use and other MF-related drug use in both countries.
METHODS: Retrospective private database analysis using electronic medical records from Argentina (Jan-2010 to Dec-2022) and claims from Brazil (Jan-2015 to Dec-2022). Eligible patients included adults (aged ≥18 years at index) with ≥1 MF-related term/code (ICD-10 D47.1/C94.5). Index (proxy for MF diagnosis) was the first date of code. Frequency of treatment accumulated per calendar year was described.
RESULTS: Of 228 patients with MF identified in Argentina and 334 in Brazil, 64.9% (n=148/228) and 54.8% (n=183/334) received treatment, respectively. Ruxolitinib (RUX) and hydroxyurea (HU) were the most common MF-related drug treatments. In Argentina RUX was initially approved in 2013; usage increased from 5.0% in 2013 to 17.8% in 2018, followed by a reduction to 3.9% in 2022. In parallel, HU use increased (45.5% in 2010 vs. 80.5% in 2022). In Brazil, increasing usage of RUX was observed, from 12.2% in 2016 to 55.3% in 2022, whereas HU use decreased (38.7% in 2015 vs. 13.2% in 2022). Among the erythropoiesis-stimulating agents, epoetin alfa was the most used, with a reduction seen in both countries (Argentina: 81.8% in 2010 vs. 26.0% in 2022; Brazil: 58.1% in 2015 vs. 52.6% in 2022).
CONCLUSIONS: RUX and HU were the most commonly used drugs to treat MF in Argentina and Brazil but followed different usage trends. Most patients are still receiving treatment with HU in Argentina, whereas HU is now less commonly prescribed in Brazil. As alternative JAKis addressing all manifestations of MF become available, a shift in initial treatment options favoring those agents is expected.