Comorbidities and Conmedication Use In Patients with Chronic Myelogenous Leukemia.

Few studies have evaluated the presence of comorbidities and the complexity of conmedication among CML patients in the real-world setting. No studies have used automated claims and medical record review to obtain comprehensive CML diagnosis, treatment, comorbidity, and conmedication information.

Medical and pharmacy claims from HealthCore Integrated Research Database™ (8.5 million covered US lives during study time period) were used to identify patients with CML (2001 – 2005). Information on comorbidities and conmedications was obtained using claims data supplemented with medical record review. For the current analysis, conmedication use and the presence of comorbidities were assessed for one year following imatinib initiation.

Two hundred and sixteen CML patients treated with imatinib were included in this analysis. Mean age at imatinib initiation was 51 years and 42.6% were female. The mean number of unique medications for treated patients was 19 (median = 9) in the one-year follow-up. Of all medications prescribed within 1-year of CML treatment initiation, approximately 40% had dosing restrictions (i.e. administration required with/without meals) and dosing of more than once per day. The proportion of patients experiencing 1, 2, 3, and 4+ comorbidities was 22%, 16%, 17%, and 29%, respectively. Analyses were also conducted to explore the complexity (based on dosing guidelines and intake restrictions) of each medication and specific comorbidities. Thirty-four percent % of the conmedications had no intake restrictions while 11% had specific intake restrictions (e.g. take on empty stomach) and 15% had dosing guidelines of more than once per day. Forty-one percent of conmedications had both dosing restrictions and dosing of more than once per day.

In addition to their CML diagnosis, patients experience a number of other comorbidities, some of which require complex management regimens. This is the first study to use medical record review to validate exposure and CML diagnosis and use claims and medical record review to obtain comprehensive information on comorbidities and conmedications. Additional data are being collected (and will be presented) on this cohort to extend follow-up through 2010, expand the number of CML patients included, and obtain complete information on all CML treatments and comorbidities.

Hirji:Bristol-Myers Squibb: Employment. Davis:Bristol-Myers Squibb: Employment.