Women with Newly Diagnosed Uterine Fibroids: Treatment Patterns and Cost Comparison for Select Treatment Options

Abstract BACKGROUND This study aims to describe real world characteristics and outcomes of newly-diagnosed glioblastoma multiforme (GBM) patients in relationship to O6-methylguanine DNA methyltransferase promoter (MGMT) testing and methylation status, in the US. METHODS Patients receiving care for GBM were identified in the US Oncology Network database from 1/1/2013 to 6/30/2018 and followed up to 9/30/2018. Structured data and chart reviews were used to assess demographic and clinical characteristics, treatment patterns, type of surgery, MGMT methylation, and clinical outcomes. RESULTS Of 600 patient charts planned for review, 195 have been randomly selected and reviewed thus far. Of these, 165 (84.6%) had surgical resection and 30 (15.4%) had biopsy only. Eighty-eight (45.1%) patients were tested for MGMT status and 107 (54.9%) were not. Of those tested, 33 (37.5%) were methylated, and 45 (51.1%) unmethylated. Median ages in the overall (including tested and untested), methylated and unmethylated cohorts were 63.7, 58.8, and 66.7 years, respectively. Most common first-line (1L) treatment in overall, methylated, and unmethylated cohorts was radiation concurrent with temozolomide received by 86.2%, 93.9%, and 91.1%, respectively. Median duration of 1L treatment in the overall cohort was 15.1 weeks (95% confidence interval [CI]: 11.9, 21.6) and higher in the methylated vs. unmethylated cohort (25.9 [18.1, 34.6] vs. 15.1 [9.3, 23.4] weeks, p=0.0375). Unadjusted median overall survival and progression-free survival in the overall cohort were 11.4 [9.4, 14.0] months and 5.2 [3.9, 5.8] months, and higher in the methylated vs. unmethylated cohort (20.5 [14.9, not realized] vs. 12.2 [7.1, 17.0] months, p=0.0052, and 9.4 [5.6, 14.0] vs. 5.5 [3.3, 6.8], p=0.0092, respectively). CONCLUSIONS Fewer than half of GBM patients were tested for MGMT methylation in the US community. Clinical outcomes, while better among patients with methylated MGMT, remain poor and current treatment options are limited.

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Surgical Treatment Patterns for Women with Newly Diagnosed Uterine Fibroids: Trends from 2010-2014

Journal of Minimally Invasive Gynecology ◽

10.1016/j.jmig.2016.08.631 ◽

2016 ◽

Vol 23 (7) ◽

pp. S183-S184

Author(s):

M Bonafede ◽

S Pohlman ◽

E Riehle ◽

N Adolph ◽

K Troeger

Keyword(s):

Surgical Treatment ◽

Uterine Fibroids ◽

Treatment Patterns ◽

Newly Diagnosed

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Survival, costs, and health care resource use by line of therapy in US Medicare patients with newly diagnosed glioblastoma: a retrospective observational study

Neuro-Oncology Practice ◽

10.1093/nop/npz042 ◽

2019 ◽

Author(s):

Abdalla Aly ◽

Prianka Singh ◽

Beata Korytowsky ◽

You-Li Ling ◽

Hrishikesh P Kale ◽

...

Keyword(s):

Overall Survival ◽

Observational Study ◽

Resource Use ◽

Treatment Options ◽

Skilled Nursing Facility ◽

Treatment Patterns ◽

Retrospective Observational Study ◽

Newly Diagnosed ◽

Medicare Patients

Abstract Background Glioblastoma (GBM) is associated with poor prognosis, large morbidity burden, and limited treatment options. This analysis evaluated real-world treatment patterns, overall survival, resource use, and costs among Medicare patients with GBM. Methods This retrospective observational study evaluated Medicare patients age 66 years or older with newly diagnosed GBM using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data from 2007 through 2013. Patients were followed from diagnosis to death or end of follow-up. An algorithm defined treatment patterns as lines of therapy (LOTs). The Kaplan-Meier method was used to estimate overall survival for the full sample as well as by LOT, surgical resection, Charlson Comorbidity Index (CCI), tumor size, and age. Resource use and costs during the follow-up period were reported in terms of total and per-patient-per-month (PPPM) estimates. Results A total of 4308 patients with GBM were identified (median age, 74 years; CCI of 0, 52%). The most commonly used first LOT was temozolomide (82%), whereas chemotherapy + bevacizumab was most prevalent for second-line (42%) and third-line (58%) therapy. The median overall survival was 5.9 months for resected patients and 3 months for unresected patients, with considerable heterogeneity depending on patient characteristics. A great proportion of patients had claims for an ICU admission (86.2%), skilled nursing facility (76.9%), and home health (56.0%) in the postdiagnosis period. The cumulative mean cost was $95 377 per patient and $18 053 PPPM, mostly attributed to hospitalizations. Conclusions Limited treatment options, poor survival, and economic burden emphasize the need for novel interventions to improve care for Medicare patients with GBM.

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Treatment Patterns for Women with Newly Diagnosed Uterine Fibroids

Journal of Minimally Invasive Gynecology ◽

10.1016/j.jmig.2014.08.463 ◽

2014 ◽

Vol 21 (6) ◽

pp. S135

Author(s):

M.M. Bonafede ◽

K.A. Cappell ◽

S.K. Pohlman ◽

K.A. Troeger

Keyword(s):

Uterine Fibroids ◽

Treatment Patterns ◽

Newly Diagnosed

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Utilization and Treatment Patterns of Disease-Modifying Therapy Among Pediatric Patients With Multiple Sclerosis in the United States

International Journal of MS Care ◽

10.7224/1537-2073.2019-095 ◽

2020 ◽

Author(s):

Greenberg Benjamin ◽

Scott Kolodny ◽

Mengru Wang ◽

Chinmay Deshpande

Keyword(s):

Multiple Sclerosis ◽

Index Date ◽

Pediatric Patients ◽

Treatment Options ◽

The United States ◽

Treatment Patterns ◽

Considerable Proportion ◽

Newly Diagnosed ◽

Disease Modifying Therapy ◽

Disease Modifying

Abstract Background: The current landscape and treatment patterns of disease-modifying therapy (DMT) use among pediatric patients with multiple sclerosis (MS) is not yet well understood. This study examined DMT utilization and treatment patterns among pediatric patients newly diagnosed with MS. Methods: Pediatric patients (<18 years) with 2 MS diagnosis claims from January 1, 2010, to December 31, 2016, were identified from the MarketScan Commercial Database. Index date was defined as the date of first MS diagnosis and patients were followed up for 1-year post-index date. Outcomes evaluated included percentage of patients who initiated treatment after MS diagnosis, different DMTs initiated, treatment discontinuation, and switching treatment over the follow-up period. Results: Of the 182,057 newly diagnosed MS patients, 288 pediatric patients (mean age: 14 years; females: 61%) were identified. Within the first year of diagnosis, 188 patients (65.3%) did not receive any DMT. The most commonly first initiated treatments were interferons and glatiramer acetate (83%), but 28% of patients switched or discontinued from first initiated treatment within 6 months of treatment initiation. Conclusions: This study suggests that a considerable proportion of pediatric MS patients remain untreated within one year. Patients most commonly initiated injectables as their first DMT. Overall approximately 1 in 3 patients failed on therapy early. Thus, the study warrants urgency in treating these patients with currently approved treatment options.

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Treatment Patterns in Patients with Newly Diagnosed Type 2 Diabetes in 2015

Diabetes ◽

10.2337/db18-1648-p ◽

2018 ◽

Vol 67 (Supplement 1) ◽

pp. 1648-P

Author(s):

JIANMIN WU ◽

JIN XIE ◽

HOONG WONG-JACOBOSN SIEW ◽

VIRGINIA S. HAYNES ◽

ZHENXIANG ZHAO

Keyword(s):

Type 2 Diabetes ◽

Treatment Patterns ◽

Newly Diagnosed

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Clinical Characteristics and Early Treatment Patterns of Newly Diagnosed Cystic Fibrosis–Related Diabetes in Two Tertiary Centers

Diabetes ◽

10.2337/db18-2374-pub ◽

2018 ◽

Vol 67 (Supplement 1) ◽

pp. 2374-PUB

Author(s):

ERIN MCCORRY ◽

HIBA BASHEER ◽

JORGE E. LASCANO ◽

JOHN YOON ◽

JULIO A. LEEY

Keyword(s):

Cystic Fibrosis ◽

Early Treatment ◽

Clinical Characteristics ◽

Treatment Patterns ◽

Newly Diagnosed

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Treatment patterns and outcomes in elderly patients with newly diagnosed multiple myeloma: results from the Connect® MM Registry

Blood Cancer Journal ◽

10.1038/s41408-021-00524-1 ◽

2021 ◽

Vol 11 (7) ◽

Author(s):

Hans C. Lee ◽

Sikander Ailawadhi ◽

Cristina J. Gasparetto ◽

Sundar Jagannath ◽

Robert M. Rifkin ◽

...

Keyword(s):

Multiple Myeloma ◽

Elderly Patients ◽

Treatment Patterns ◽

Newly Diagnosed

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TREATMENT PATTERNS OF NEWLY DIAGNOSED PEDIATRIC ULCERATIVE COLITIS AND CROHN’S DISEASE PATIENTS IN THE IMPROVECARENOW REGISTRY

Inflammatory Bowel Diseases ◽

10.1093/ibd/izaa347.050 ◽

2021 ◽

Vol 27 (Supplement_1) ◽

pp. S22-S23

Author(s):

Theresa Hunter ◽

Wendy Komocsar ◽

Richard Colletti ◽

Chunyan Liu ◽

Keith Benkov ◽

...

Keyword(s):

United States ◽

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

The United States ◽

Current Treatment ◽

Treatment Patterns ◽

Initial Visit ◽

Newly Diagnosed ◽

Time Points

Abstract Objectives The objective of this study was to assess current treatment patterns of pediatric ulcerative colitis (UC) and Crohn’s disease (CD) patients, using data in the ImproveCareNow (ICN) registry. Methods Pediatric (2–17 years) patients in the United States who were newly diagnosed with UC or CD between June 1, 2013-December 31, 2019, who had their first recorded ICN visit within 6 months of diagnosis and who were actively followed for at least 12 months (± 90 days) were included in this study. Descriptive statistics of baseline patient demographics were summarized for the overall IBD patient population and separately for UC and CD. Treatment patterns (including use of corticosteroids, 5-aminosalicylic acid (5-ASA), 6-mercaptopurine/azathioprine (6-MP/AZA), methotrexate, tumor necrosis factor inhibitors (TNFi) [adalimumab, infliximab, certolizumab, golimumab, and their biosimilars], ustekinumab, vedolizumab, and other medications [natalizumab and tofacitinib]) were assessed at the initial baseline visit, and at 1-year and 3-year time points. Results A total of 6,504 pediatric IBD patients (UC=1,784; CD=4,720) were included in this study. Patients had a mean age at diagnosis of 13.0 years (UC=13.2; CD=12.9), 57.1% were male (UC=49.6%; CD=60.0%), and 81.0% were White (UC=81.2%; CD=81.0%) (Table 1). At the initial ICN visit, 46.4% of UC patients were prescribed a corticosteroid, while 19.8% received a 5-ASA, 12.6% received a TNFi, 10.4% received a 6-MP/AZA, 3.0% received methotrexate, and 0.3% received vedolizumab. At the initial visit, 40.2% of CD patients were prescribed a corticosteroid, while 29.1% received a TNFi, 18.5% received a 6-MP/AZA, 12.4% received methotrexate, and 3.3% received a 5-ASA. At the 1-year and 3-year time points, rates of 5-ASA and corticosteroid use decreased among UC patients; however, rates of 6-MP/AZA, methotrexate, and TNFi increased (Table 2). Similarly, at the 1-year and 3-year time points, rates of corticosteroids among CD patients decreased; however, rates of methotrexate and TNFi increased (Table 2). There was also an increase in use of ustekinumab and vedolizumab over time among UC and CD patients. Conclusion These results highlight the current treatment patterns of pediatric UC and CD patients in the United States. At the initial ICN visit, the 46% of UC and 40% of CD patients were receiving corticosteroids, however, at 1-year and 3-years after initial visit, over 30% of UC patients and over 60% of CD patients were receiving TNF inhibitors with considerably reduced corticosteroid use.

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