BACKGROUND:In Mexico, FMS-like tyrosine kinase 3 (FLT3) inhibitors have been approved for newly diagnosed or relapsed/refractory (R/R) FLT3-positive (FLT3+)acute myeloid leukemia (AML). This retrospective, physician panel-based chart review study evaluated the real-world treatment landscape, clinical outcomes, and healthcare resource utilization (HRU) in patients with FLT3+ R/R AML in Mexico. METHODS:This retrospective, non-interventional chart review utilized de-identified data from existing charts collected from 04/26/2022-07/18/2022. RESULTS:Of 165 patients, a phased treatment strategy (ie, an induction phase followed by consolidation and/or maintenance phase) was used in 63% of patients, with 7.3% undergoing hematopoietic stem cell transplantation (HSCT) in the first-line (1 L) setting. In the second-line (2 L) R/R setting, 18.2% received phased treatment and 4.2% underwent HSCT. Any type of complete remission (CR) was achieved in 78.1% of patients after 1 L induction; 75.8% relapsed, and 24.2% were refractory to 1 L. After 2 L induction, 79.2% of patients achieved any type of CR. Median overall survival and event-free survival were 21.7 and 13.6 months. Time to relapse after initial AML diagnosis was 13.7 months, and 10.9 months after HSCT at any line of treatment. Median time to HSCT after first diagnosis of R/R disease was not reached. HRU burden was high before and after diagnosis of R/R disease. CONCLUSION:This is the first multi-center study conducted in Mexico among patients with FLT3+ R/R AML. Despite high remission rates following 1 L induction therapy, patients experienced disease progression and HRU remained high, indicating an unmet need. Future studies are warranted to assess how outcomes evolve with novel treatments. CLINICALTRIALS: GOV IDENTIFIER:Not applicable.

Background: Control of disease-related symptoms is a goal of chemotherapy for patients with locally advanced (LA) unresectable or metastatic gastric/gastroesophageal junction (mG/GEJ) adenocarcinoma. This study describes disease-related symptoms and healthcare resource utilization (HRU) in this population. Methods: A retrospective review of adult patients with claudin 18.2–positive (CLDN18.2+), human epidermal growth factor receptor 2–negative (HER2−), LA unresectable or mG/GEJ adenocarcinoma was performed. Outcomes were assessed from the index date (date of diagnosis) through the follow-up end date (earliest of first-line treatment discontinuation, last follow-up visit, death, or 1 year after index date). Results: Sixty-two patients were included in the analysis (mean age, 61.3 years; 54.8% male; 88.7% White; 67.7% had gastric primary tumors; 75.8% had peritoneal metastases; 98.4% received first-line treatment [mean time from diagnosis to treatment initiation, 37.0 days]). All patients reported ⩾1 disease-related symptom (mean = 7.2) at the index date. The most common symptoms at the index date were weight loss (74.2%), abdominal pain/stomach pain (66.1%), anemia/weakness (61.3%), poor appetite (56.5%), and epigastric pain (50.0%). Of the 21 patients evaluated at the 6-month follow-up, 95.2% reported ⩾1 disease-related symptom. The greatest changes were seen for weight loss (0.0% at 6 months vs 74.2% at the index date), epigastric pain (9.5% vs 50.0%), poor appetite (23.8% vs 56.5%), reflux (4.8% vs 35.5%), early satiety (0.0% vs 29.0%), and abdominal pain/stomach pain (38.1% vs 66.1%). A mean of 3.4 outpatient visits per patient per month was reported (mean follow-up, 6.5 months), 21.0% of patients had an inpatient admission, and 35.5% had an emergency department visit. Conclusions: This study demonstrates substantial disease-related symptom burden and high HRU for patients with CLDN18.2+, HER2−, LA unresectable or mG/GEJ adenocarcinoma.

BACKGROUND:Three covalent Bruton's tyrosine kinase inhibitors (BTKis) are approved first-line (1L) treatments for patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). However, limited real-world data, especially in veterans, evaluate long-term outcomes associated with the different BTKis. OBJECTIVE:To describe and compare real-world overall survival (rwOS) among patients with CLL/SLL treated with BTKis in the Veterans Health Administration electronic medical record database. METHODS:This was a retrospective cohort study of patients with CLL/SLL who initiated 1L monotherapy of ibrutinib, acalabrutinib, or zanubrutinib between November 2019 and September 2023. Patients were grouped into 3 cohorts based on the BTKi initiated: (1) ibrutinib, (2) acalabrutinib, or (3) acalabrutinib or zanubrutinib (given small sample initiating zanubrutinib). Key inclusion criteria were 1L monotherapy treatment with a BTKi, at least 2 diagnoses of CLL/SLL, and continuous enrollment at least 12 months prior to and at least 28 days after the initiation of the BTKi. rwOS comparing the BTKi cohorts was analyzed using Kaplan-Meier methodology and adjusted Cox proportional hazards models. Sensitivity analyses adjusting for different sets of covariates were conducted. RESULTS:The study included samples of 1,059, 504, and 612 patients treated with ibrutinib, acalabrutinib, and acalabrutinib or zanubrutinib (108 received zanubrutinib), respectively. Median rwOS was not reached in any cohort. In the main analysis comparing the ibrutinib and acalabrutinib cohorts, after adjustment for baseline characteristics, treatment with acalabrutinib was associated with an increased risk of death compared with ibrutinib (hazard ratio [HR], 1.33; 95% CI, 1.01-1.76; P = 0.042). In the main analysis comparing the ibrutinib and acalabrutinib or zanubrutinib cohorts, the adjusted risk of death was numerically higher for acalabrutinib- or zanubrutinib-treated patients compared with ibrutinib (HR, 1.32; 95% CI, 1.00-1.74; P = 0.050). For both comparisons, sensitivity analyses indicated similar trends in rwOS. CONCLUSIONS:As new therapies emerge, this study highlights the comparative effectiveness of BTKis in the real world, potentially informing current clinical practice.

Despite concerted efforts of healthcare agencies, haemophilia treatment coverage remains inadequate in China. This real-world study was conducted to understand patient characteristics, clinical and economic burden, and treatment patterns amongst patients with haemophilia A in China with the aim of improving patient outcomes and quality of life. Two data sources, namely the National Haemophilia Registry and Institute of Haematology and Blood Diseases Hospital, were used to analyse the disease burden, treatment patterns and economic burden of haemophilia A in China. The economic burden was assessed from 2017 to 2019. Overall, 3164 male patients with haemophilia A (mean age 21.5 years) were analysed. Almost half (48.3

BackgroundCOVID-19 continues to pose a significant health burden, particularly among older adults. mRNA-1283 is a next-generation COVID-19 mRNA vaccine developed to enhance immune response. Findings from the Phase 3 NextCOVE trial comparing bivalent versions of mRNA-1273 and mRNA-1283 vaccines have recently become available. However, there are no head-to-head trials comparing mRNA-1283 and the BNT162b2 vaccine.ObjectiveTo indirectly compare the effectiveness of mRNA-1283 and BNT162b2 against symptomatic COVID-19 among adults in the US.MethodsA targeted literature review was conducted to identify relevant studies comparing the mRNA-1273 and BNT162b2 bivalent vaccines. A real-world evidence (RWE) study by Kopel et al. (2023) assessing the relative vaccine effectiveness (rVE) of mRNA-1273 vs. BNT162b2 was selected for an indirect treatment comparison (ITC) against the NextCOVE trial using the Bucher method. Analyses were stratified by age group and sensitivity analyses were conducted using alternative outcome definitions.ResultsDespite differences between NextCOVE and the Kopel study, comparability assessments supported a robust ITC. Among participants >= 18 years of age, the indirect rVE of mRNA-1283 vs. BNT162b2 against symptomatic COVID-19 was 15.3% (95% CI = 4.7-24.8%, p = 0.006). For adults >= 65 years of age, the rVE was 22.8% (95% CI = 3.7-38.1%, p = 0.022). Sensitivity analyses with alternative outcome definitions supported these estimates.ConclusionThis analysis provides consistent and statistically significant evidence indicating the next-generation mRNA-1283 vaccine is more effective in preventing symptomatic COVID-19 than BNT162b2, with the largest effect in individuals aged >= 65. Consistent results across sensitivity analyses underscore the robustness of the findings, offering important evidence to inform vaccination decisions by policymakers, providers, and payers.

Introduction:For acute myeloid leukemia (AML), prognosis is particularly poor in patients harboring FMS-like tyrosine kinase 3 (FLT3) gene mutations, though routine screening for these mutations at diagnosis has been shown to be insufficient. The understanding of the impact of FLT3 mutations on treatment decisions is limited.Methods:In this retrospective, observational study, we investigated the key epidemiological characteristics, treatment patterns and responses among adult patients with newly diagnosed (ND) AML in China, who initiated treatment from January 1, 2015, to December 31, 2019, or progressed to relapsed/refractory (R/R) AML by December 31, 2020.Results:Of the 853 ND AML patients included, 63.4% were screened for FLT3 status, and 20.1% tested positive (FLT3MUT) at initial diagnosis. Of 289 patients who progressed to R/R AML during the study period, 24.9% were screened at the diagnosis of R/R AML, and 19.4% tested positive; 20.5% of screened patients changed FLT3 status at first diagnosis of R/R AML. Initial treatment regimens or treatment responses did not seem to differ in patients with ND AML by FLT3 mutation status. In patients with R/R AML, there was an apparent difference in second-line treatment choices by FLT3 mutation status; however, the number of FLT3-mutated patients were limited to demonstrate any meaningful distinction. FLT3-mutated R/R AML was associated with shorter relapse time.Conclusion:Study findings showed that there was a lack of routine testing for FLT3 mutations at first diagnosis of R/R AML, and initial treatment decisions did not differ by FLT3 mutation status. Given the clinical burden of FLT3MUT, likelihood of FLT3 status changes, and emerging FLT3 inhibitors, further routine FLT3 screening is needed to optimize treatment of R/R AML.

This retrospective study described the real-world symptoms of patients with CLDN18.2+, HER2−, LA unresectable or mG/GEJ adenocarcinoma and the healthcare resource utilization (HRU) in this population.

Objective: This study used real-world population data to assess the trends of first-line (1L) poly(ADP-ribose) polymerase inhibitor (PARPi) maintenance treatment uptake and outcomes in patients with primary advanced ovarian cancer (AOC). Methods: Patients diagnosed with AOC between January 1, 2017, and June 30, 2021, who completed 1L chemotherapy were selected from a real-world database. Descriptive analyses were performed to evaluate patient demographics, clinicopathological characteristics, and 1L treatment patterns. Time to next treatment or death was used as a proxy for real-world progression-free survival (rwPFS). Kaplan-Meier methods and Cox models were used for statistical analyses. Results: Of 705 patients who completed 1L chemotherapy, 166 received PARPi monotherapy and 539 underwent active surveillance (AS). Median follow-up was 10.9 months for PARPi monotherapy and 20.6 months for AS. PARPi monotherapy use increased from 6% in 2017 to 53% in 2021. Overall, patients receiving PARPi monotherapy had longer rwPFS than those who underwent AS (not reached vs 9.53 mo) respectively. rwPFS was also longer in patients who received PARPi monotherapy compared with AS in patients with BRCA-mutated disease (not reached vs 11.4 mo), BRCA–wild-type disease (13.5 vs 9.1 mo), homologous recombination-deficient tumors (not reached vs 10.2 mo), and homologous recombination-proficient or unknown status tumors (13.5 vs 9.3 mo). Conclusions: Our real-world analysis suggested that 47% of patients with primary AOC did not receive PARPi maintenance in the year 2021. PARPi use was associated with significantly improved outcomes compared with AS.

Background: Studies on real-world treatment patterns and long-term economic burden of Parkinson's disease (PD) have been limited. Objective: To assess treatment patterns, healthcare resource utilization (HRU), and costs associated with PD symptoms and treatment-related adverse events (AEs) among Medicare beneficiaries in the United States.Methods: A 100% Medicare Fee-For-Service data (2006-2020) of patients with PD were analyzed. PD treatment patterns were described for the subset of patients who had no previously observed PD treatments or diagnoses (ie, the incident cohort). HRU and healthcare costs associated with PD symptoms were assessed for all patients with PD (ie, the overall cohort) and that associated with treatment-related AEs were assessed for the subset of patients who received PD treatments after PD diagnosis (ie, the active treatment cohort), using longitudinal models with repeated measures.Results: Overall, 318,582 patients were included (mean age at PD diagnosis: 77.4 years; 53.3% female). Among patients in the incident cohort (N=214,829), 51.1% initiated levodopa monotherapy and 5.9% initiated dopamine agonists (DAs) monotherapy as first-line treatment. The proportion of incident patients treated with DAs and other PD therapies generally increased from postdiagnosis years 1 to 10. The median time from diagnosis to PD treatment initiation was 2.0 months; the median time to treatment discontinuation was the longest with levodopa (18.7 months), followed by DAs (9.5 months). In the overall cohort, PD symptoms, especially motor symptoms and severe motor symptoms, were associated with significantly higher rates of HRU and costs. In the active treatment cohort (N=234,298), treatment-related AEs were associated with significantly higher rates of HRU and medical costs.Conclusion: While levodopa is still the mainstay of PD management, considerable heterogeneity exists in real-world treatment patterns. Overall, PD symptoms and AEs were associated with significantly higher HRU and healthcare costs, suggesting unmet medical needs for PD treatments with better tolerability profiles.

Atopic dermatitis (AD) can require long-term therapy. Few real-world studies have evaluated long-term effectiveness from the patients’ perspective. The aim of this study was to evaluate patient-reported outcomes (PROs) during long-term dupilumab treatment. Adults with moderate-to-severe AD who initiated dupilumab through the US manufacturer patient support program and participated in RELIEVE-AD (a prospective patient survey study with a 12-month follow-up) were recontacted 30–36 months post-initiation regardless of current dupilumab use. The online questionnaire consisted of PROs, including the Atopic Dermatitis Control Tool (ADCT), use of concomitant AD therapies, satisfaction with current therapy, global change in itch relative to before dupilumab initiation, non-itch skin symptoms (skin pain/soreness, hot/burning feeling, and sensitivity to touch), flares, Dermatology Life Quality Index, sleep problems, and the AD-specific Work Productivity and Activity Impairment Questionnaire. Of 698 patients who initiated dupilumab (baseline) and were recontacted, 425 completed the 30–36-month survey. Significant reductions from baseline were reported in concomitant AD therapy use (P < 0.05); 54.4

Eosinophilic gastritis and eosinophilic enteritis (EoG/EoN) are associated with a substantial clinical burden. However, limited information is available regarding the economic burden of EoG/EoN. This study was conducted to compare healthcare resource use (HRU) and costs among patients with EoG/EoN versus without EoG/EoN in the USA. Administrative claims data from the IBM MarketScan® Commercial Claims and Encounters (CCAE) and Medicare Supplemental and Coordination of Benefits Databases (2009–2019) was used to identify two cohorts of patients. Patients without EoG/EoN were matched 3:1 to patients with EoG/EoN on sex, year of birth, and healthcare plan type. Study measures included demographic characteristics, select comorbidities, all-cause HRU, and costs. Comparisons were made over a 1-year period following EoG/EoN diagnosis for patients with EoG/EoN and an eligible date for patients without EoG/EoN. A total of 2219 patients with EoG/EoN and 6657 patients without EoG/EoN were analyzed. Significantly higher proportions of patients with EoG/EoN versus without EoG/EoN had comorbid conditions. Rates of all-cause HRU were significantly higher among patients with EoG/EoN versus patients without EoG/EoN (adjusted rate ratio [95% confidence interval]: inpatient visits, 6.26 [5.26, 7.46]; outpatient visits, 1.17 [1.16, 1.19]; emergency department visits, 2.11 [1.98, 2.25]; all p < 0.001). Patients with EoG/EoN incurred significantly higher costs versus patients without EoG/EoN (adjusted mean cost difference $31,180; p < 0.001). Cost differences were largely due to outpatient (adjusted mean cost difference $14,018; p < 0.001) and inpatient (adjusted mean cost difference $11,224; p < 0.001) costs. The economic burden associated with EoG/EoN is substantial, with patients with EoG/EoN having a higher rate of HRU and incurring $31,180 more than patients without EoG/EoN on average. Most of the cost difference was attributable to outpatient and inpatient costs. Cost-saving strategies to lower the burden of illness in this patient population are needed.

6580 Background: Since 2018, the FDA has approved 2 PARP inhibitors (PARPi), niraparib and olaparib, for first-line (1L) maintenance therapy for OC. Using real-world population data, we assessed trends of 1L PARPi maintenance treatment uptake and PFS of pts with newly diagnosed AOC. Methods: Pts diagnosed with AOC between January 1, 2017, and June 30, 2021, who completed 1L chemo were identified from the nationwide Flatiron Health electronic health record (EHR)-derived de-identified database. We calculated descriptive statistics describing pt demographics, clinico-pathological characteristics, and 1L treatment patterns. The use of PARPi or active surveillance (AS) was identified during a 120-day period after the last dose of 1L chemo. The end of the 1L treatment identification period was defined as the index date. Time to next treatment was used as a proxy for PFS and was defined as time from the index date to the next therapy, last clinical activity, end of study period, or death. Kaplan-Meier methods and Cox models were used to analyze the PFS endpoint. Results: A total of 705 pts were included in the study; 166 received PARPi monotherapy (PARPi mono) and 539 underwent AS after completion of 1L chemo. Median age was 68 y for AS vs. 65 y for PARPi mono (Table). Median time from last chemo to initiation of PARPi mono was 48.5 d. Median follow-up was 20.6 mo for AS and 10.9 mo for PARPi mono. In the overall group, median PFS (mPFS) was 9.53 mo for AS vs. not reached (NR) for PARPi mono. In those with BRCA mutations ( BRCAm), corresponding mPFS was 11.4 mo vs. NR and for BRCA wild type ( BRCAwt) was 9.1 mo vs. 13.5 mo. On multivariate analysis, 1L PARPi maintenance was an independent predictor for improved PFS when compared to AS in all pts (HR, 0.47; 95% CI, 0.34-0.63), BRCAm (HR, 0.17; 95% CI, 0.07-0.41) and BRCAwt (HR, 0.50; 95% CI, 0.35-0.72). Stage IV at initial diagnosis, no debulking surgery, residual disease, and BRCAwt status were associated with poorer PFS. Trends analysis over the 4-year study period showed PARPi mono use increased from 6% in 2017 to 53% in 2021. Conclusions: This real-world analysis shows that adoption of PARPi mono in the 1L maintenance setting in pts with newly diagnosed AOC has increased to 53% in 2021. PARPi use, when compared with AS, was associated with significantly improved mPFS in both pts with BRCAm and BRCAwt. [Table: see text]

Objectives: With the advent of poly (adenosine diphosphate [ADP]- ribose) polymerase inhibitors (PARPi), first-line (1L) maintenance therapy in patients with ovarian cancer (OC) has evolved in recent years. This study described the use of 1L maintenance and assessed predictors of 1L PARPi maintenance therapy use among PARPi- eligible patients with OC in a real-world setting. Methods: This retrospective cohort study included patients with newly diagnosed stage III/IV epithelial OC who received the last dose of 1L platinum-based chemotherapy (PBC) between January 1, 2017, and February 28, 2021, from the nationwide Flatiron Health electronic health record-derived database. During the study period, the de-identified data originated from approximately 280 US cancer clinics. The end of the last cycle of 1L PBC was defined as the index date. Patients who started a second-line treatment within two months of the index date were excluded. Multivariable logistic regression was used to identify predictors of 1L PARPi monotherapy use versus active surveillance (AS). Variables included in the model were selected using the stepwise approach. Results: A total of 1010 patients were included in the study; 37.9% and 62.1% of patients received maintenance therapy and AS, respectively. A total of 162 (16.0%) patients received PARPi monotherapies (niraparib 6.3%, olaparib 8.7%, and rucaparib 1.0%), 122 (12.1%) received bevacizumab monotherapy, 33 (3.3%) received bevacizumab + PARPi combination therapies and 66 (6.5%) received other therapies. The median age was 68.0 years (Q1:58.0; Q3:75.0) for AS and 65.0 years (56.0; 71.8) for PARPi monotherapies. Other patient characteristics are shown in Table 1. Patients with BRCA mutation were significantly more likely to receive PARPi monotherapies (odds ratio [OR]: 7.49; 95% CI: 4.21-13.31) than patients with BRCA wild-type. Patients treated in 2019 (OR: 7.57; 95% CI: 3.86-14.86) and 2020 (OR: 14.99; 95% CI: 7.61-29.53) were significantly more likely to receive PARPi monotherapies than patients treated in 2017. Race, region of residence, practice type, FIGO stage at initial diagnosis, Eastern Cooperative Oncology Group (ECOG) score, residual disease status, and other disease characteristics were not selected into the model. Conclusions: Over the last four years, the use of 1L PARPi maintenance among ovarian cancer patients has increased significantly, mostly driven by biomarker status. However, stage and extent of residual disease after surgery were not associated with PARPi maintenance use. Objectives: With the advent of poly (adenosine diphosphate [ADP]- ribose) polymerase inhibitors (PARPi), first-line (1L) maintenance therapy in patients with ovarian cancer (OC) has evolved in recent years. This study described the use of 1L maintenance and assessed predictors of 1L PARPi maintenance therapy use among PARPi- eligible patients with OC in a real-world setting. Methods: This retrospective cohort study included patients with newly diagnosed stage III/IV epithelial OC who received the last dose of 1L platinum-based chemotherapy (PBC) between January 1, 2017, and February 28, 2021, from the nationwide Flatiron Health electronic health record-derived database. During the study period, the de-identified data originated from approximately 280 US cancer clinics. The end of the last cycle of 1L PBC was defined as the index date. Patients who started a second-line treatment within two months of the index date were excluded. Multivariable logistic regression was used to identify predictors of 1L PARPi monotherapy use versus active surveillance (AS). Variables included in the model were selected using the stepwise approach. Results: A total of 1010 patients were included in the study; 37.9% and 62.1% of patients received maintenance therapy and AS, respectively. A total of 162 (16.0%) patients received PARPi monotherapies (niraparib 6.3%, olaparib 8.7%, and rucaparib 1.0%), 122 (12.1%) received bevacizumab monotherapy, 33 (3.3%) received bevacizumab + PARPi combination therapies and 66 (6.5%) received other therapies. The median age was 68.0 years (Q1:58.0; Q3:75.0) for AS and 65.0 years (56.0; 71.8) for PARPi monotherapies. Other patient characteristics are shown in Table 1. Patients with BRCA mutation were significantly more likely to receive PARPi monotherapies (odds ratio [OR]: 7.49; 95% CI: 4.21-13.31) than patients with BRCA wild-type. Patients treated in 2019 (OR: 7.57; 95% CI: 3.86-14.86) and 2020 (OR: 14.99; 95% CI: 7.61-29.53) were significantly more likely to receive PARPi monotherapies than patients treated in 2017. Race, region of residence, practice type, FIGO stage at initial diagnosis, Eastern Cooperative Oncology Group (ECOG) score, residual disease status, and other disease characteristics were not selected into the model. Conclusions: Over the last four years, the use of 1L PARPi maintenance among ovarian cancer patients has increased significantly, mostly driven by biomarker status. However, stage and extent of residual disease after surgery were not associated with PARPi maintenance use.

[This corrects the article DOI: 10.36469/jheor.2022.32485.].

Background: Tenosynovial giant cell tumors (TGCT) are rare and locally aggressive neoplasms in synovium, bursae, and tendon sheaths, which cause pain, joint dysfunction, and damage to the affected joints. Objective: To evaluate the surgical patterns and economic burden among patients with TGCT who underwent joint surgery in the United States. Methods: Patients newly diagnosed with TGCT, aged 18-64 years, who underwent joint surgery post-TGCT diagnosis were identified from the OptumHealth Care Solutions, Inc database (Q1/1999-Q1/2017). Patients were required to be continuously enrolled for ≥1 year before and ≥3 years after the first TGCT diagnosis (index date). Surgical patterns were assessed post-index. Healthcare resource utilization and associated healthcare costs, and indirect costs related to work loss in year 1, year 2, and year 3 post-index, were compared with those at baseline. Results: Of 835 eligible TGCT patients, 462 (55%) patients who had ≥1 joint surgery post-index were included. During a median follow-up of 5.7 years, 78% of patients underwent their first joint surgery in year 1 and 41% had ≥1 repeat surgery. Magnetic resonance imaging utilization was highest during baseline (46%) and declined afterward (28%, 17%, and 19% in years 1, 2, and 3, respectively). Opioids and nonsteroidal anti-inflammatory drugs (NSAIDs), and physical therapy, occupational therapy, and rehabilitation services, were commonly used during baseline (45%, 40%, and 30%, respectively). More patients used opioids in year 1 vs baseline (78% vs 45%; P<0.0001), while its utilization return to baseline levels in year 2 (41%) and year 3 (42%). A similar pattern was observed for NSAIDs and physical/occupational therapy/rehabilitation services. Healthcare resource utilization and associated healthcare costs surged in year 1 and returned to baseline or lower in years 2 and 3. A similar pattern was observed for indirect costs associated with work loss. Discussion: The high proportion of patients undergoing repeat surgeries and prevalent use of opioids, NSAIDs, and physical/occupational therapy/rehabilitation services suggests an unmet medical need after surgical treatment. Conclusions: Surgical resection alone might be inadequate to control TGCT. New treatment options may complement surgery and alleviate the clinical and economic burden experienced by patients with TGCT who had received prior surgery.