Synchronization of Treatment With Erythropoiesis-Stimulating Agents and Chemotherapy
ABSTRACT
Objective: To examine the extent to which dosing of the erythropoiesis-stimulating agents (ESAs) darbepoetin alfa (DA) and epoetin alfa (EA) is synchronized with chemotherapy schedules in patients with selected nonmyeloid malignancies.
Study Design: Retrospective observational study using the Varian Medical Oncology electronic medical record database.
Methods: Patients had breast, lung, or colorectal cancer or lymphoma, and received conventional myelosuppressive chemotherapy and at least 2 ESA administrations in 2002-2007. Administration schedules of chemotherapy and ESAs were calculated and cross-tabulated. Each ESA administration was coded as occurring on the same day as chemotherapy or not. Generalized estimating equation models compared the proportion of ESAs administered on the same day as chemotherapy between DA and EA.
Results: A total of 8044 patients were included, 4484 on DA and 3560 on EA. Most patients received DA every 2 weeks, although an increasing proportion received it every 3 weeks starting in 2006. Epoetin alfa was most often administered weekly. ESA treatment occurred on the same day as chemotherapy for 70.8% of DA and 63.2% of EA administrations. More synchronization was seen with DA than EA (odds ratio = 1.45; 95% confi dence interval = 1.38, 1.52), with more frequent chemotherapy administrations, in breast or colorectal cancer versus lung cancer, in hospital-affiliated versus community-based clinics, and in patients whose lowest hemoglobin level during the chemotherapy regimen was ≥9 g/dL versus <9 g/dL.
Conclusions: Most ESA treatments were administered during the same visits as chemotherapy. The benefi ts of this synchronization for patients and medical practices warrant investigation.
(Am J Pharm Benefits. 2010;2(3):199-208)
Objective: To examine the extent to which dosing of the erythropoiesis-stimulating agents (ESAs) darbepoetin alfa (DA) and epoetin alfa (EA) is synchronized with chemotherapy schedules in patients with selected nonmyeloid malignancies.
Study Design: Retrospective observational study using the Varian Medical Oncology electronic medical record database.
Methods: Patients had breast, lung, or colorectal cancer or lymphoma, and received conventional myelosuppressive chemotherapy and at least 2 ESA administrations in 2002-2007. Administration schedules of chemotherapy and ESAs were calculated and cross-tabulated. Each ESA administration was coded as occurring on the same day as chemotherapy or not. Generalized estimating equation models compared the proportion of ESAs administered on the same day as chemotherapy between DA and EA.
Results: A total of 8044 patients were included, 4484 on DA and 3560 on EA. Most patients received DA every 2 weeks, although an increasing proportion received it every 3 weeks starting in 2006. Epoetin alfa was most often administered weekly. ESA treatment occurred on the same day as chemotherapy for 70.8% of DA and 63.2% of EA administrations. More synchronization was seen with DA than EA (odds ratio = 1.45; 95% confi dence interval = 1.38, 1.52), with more frequent chemotherapy administrations, in breast or colorectal cancer versus lung cancer, in hospital-affiliated versus community-based clinics, and in patients whose lowest hemoglobin level during the chemotherapy regimen was ≥9 g/dL versus <9 g/dL.
Conclusions: Most ESA treatments were administered during the same visits as chemotherapy. The benefi ts of this synchronization for patients and medical practices warrant investigation.
(Am J Pharm Benefits. 2010;2(3):199-208)
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