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J Comp Eff Res. 2015 Aug;4(4):327-40. doi: 10.2217/cer.15.20.

Deferasirox therapy is associated with reduced mortality risk in a medicare population with myelodysplastic syndromes.

Author information

1
Department of Internal Medicine, Section of Hematology, Yale University, New Haven, CT 06520, USA.
2
Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA.
3
Department of Organizational Systems & Adult Health, University of Maryland School of Nursing, Baltimore, MD 21201, USA.
4
Marlene & Stewart Greenebaum Cancer Center, University of Maryland, Baltimore, MD 21201, USA.
5
Novartis Pharmaceuticals Corporation, East Hanover, NJ 07936, USA.
6
Department of Health Policy & Management, Yale School of Public Health, Yale University, New Haven, CT 06520, USA.

Abstract

AIMS:

Iron overload adversely affects patients with myelodysplastic syndromes (MDS), but benefits of iron chelation therapy have not been clearly demonstrated. We examined the association between deferasirox (DFX) therapy and mortality in transfusion-receiving Medicare patients.

PATIENTS & METHODS:

MDS patients from 2005 to 2008 were identified using ICD-9 codes from 100% Medicare claims. Patients receiving ≥20 blood units were observed until death or end of study. Marginal structural models were used for estimation.

RESULTS:

3926 patients (10.1% used DFX) were observed for a mean of 48.8 weeks. Each incremental week of DFX was associated with a significant reduction in mortality risk (hazard ratio [HR]: 0.989; 95% CI: 0.983-0.996; p = 0.001).

CONCLUSION:

DFX therapy is associated with a reduced mortality risk among older MDS patients who received a minimum transfusion threshold.

KEYWORDS:

deferasirox; iron chelation therapy; iron overload; mortality; myelodysplastic syndromes

PMID:
26274794
PMCID:
PMC5549705
DOI:
10.2217/cer.15.20
[Indexed for MEDLINE]
Free PMC Article
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