P1059: real-world treatment patterns and healthcare resource utilization in myelofibrosis patients with anemia

Topic: 16. Myeloproliferative neoplasms - Clinical Background: Myelofibrosis (MF) is a chronic myeloproliferative neoplasm characterized by bone marrow fibrosis, progressive anemia, and extramedullary hematopoiesis (manifested primarily as splenomegaly). One of the most clinically important manifestations of MF is severe anemia, which is associated with fatigue, lower quality-of-life, and excess morbidity and mortality. Patients with MF who experience anemia are often managed with red blood cell (RBC) transfusions; however, transfusion-dependence increases with time and carries the additional risk of iron overload. There are limited data on real-world clinical management of anemia in patients with MF and the associated healthcare resource utilization (HCRU). Aims: To describe real-world patient characteristics, treatment patterns and HCRU in MF patients with anemia. Methods: The IQVIA PharMetrics Plus database was used to identify pharmacy, hospital, and medical claims data for adult (≥18 years) patients with ICD-9/10 codes for MF (Jan 1, 2009 to Apr 30, 2022). Patients were also required to have an ICD-9/10 code for anemia within the period from 3 months prior to the first MF code until the end of the study period; the date of the first code for anemia was considered the index date. Patients were also required to have had ≥12 months of continuous enrollment with medical and pharmacy benefits after index. Treatment patterns, clinical characteristics and per patient per year (PPPY) HCRU event rates within the 12 months after index were described for all eligible patients. HCRU was further stratified by all-cause, MF-related and anemia-related event rates, indicated by presence of MF or anemia codes on the claim record. Results: Of 11,371 patients with MF, 76.8% also had concurrent anemia. After applying eligibility criteria, a total of 1148 MF patients with anemia were evaluated. Median age at index was 62 years and 52.4% (n=602) were female, and 31.2% (n=358) received RBC transfusions with a mean (SD) number of 7.8 (11.9) transfusions. Systemic therapies for MF were received by 40.5% (n=465) of patients; ruxolitinib (17.0%; n=195) and hydroxyurea (17.6%; n=202) were the most frequently received. In patients who received supportive care therapies (40.5%; n=465), erythropoiesis-stimulating agents (epoetin alfa and/or darbepoetin alfa) were the most frequently received (16.0%; n=184). In total, 39.2% (n=450) of patients were hospitalized (median length of stay: 5.0 days), and mean (SD) all-cause total healthcare visits, total pharmacy visits and total medical visits were 68.9 (48.0), 26.9 (19.1) and 43.9 (36.1) PPPY, respectively (Figure); corresponding mean (SD) MF-related event rates were 13.1 (14.2), 7.8 (4.9) and 12.3 (16.4) PPPY, and anemia-related event rates were 14.0 (21.2), 3.0 (0) and 14.0 (21.2) PPPY, respectively. When stratifying medical visits by type, mean (SD) event rates for all-cause hospitalization/inpatient admissions, outpatients visits and emergency room visits were 2.2 (1.9), 42.4 (35.0) and 2.4 (2.3) PPPY, respectively; MF-related event rates were 1.5 (1.2), 12.8 (16.6) and 1.7 (1.0) PPPY, and anemia-related event rates were 1.8 (1.4), 13.9 (21.0) and 1.6 (1.1) PPPY, respectively. Summary/Conclusion: Approximately three-quarters of MF patients experienced anemia. Transfusions were frequently used as supportive care in these patients. MF patients with anemia incurred substantial HCRU burden in routine clinical practice. More effective therapies are required to address the unmet need of anemia burden in patients with MF.Keywords: Real world data, Anemia, Myelofibrosis