Universität zu Köln

Scheid, Christof, Kudernatsch, Robert, Eckart, Marie, Feig, Chiara, Straub, Vincent, Libutzki, Berit and Mahlich, Joerg (2022). Treatment Pathways and Health Outcomes of German Patients with Chronic Graft-Versus-Host Disease After Allogeneic Hematopoietic Cell Transplantation: A Retrospective Health Claims Data Analysis. Drugs-Real World Outcomes, 9 (4). S. 577 - 589. LONDON: SPRINGERNATURE. ISSN 2198-9788

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Abstract

Background Although chronic graft-versus-host-disease (cGvHD) is an important long-term complication after allogenic hematopoietic cell transplantation (allo-HCT) and is associated with increased healthcare resource utilization, real-world evidence is scarce. Objectives The aim of the study was to evaluate survival of patients with cGvHD in Germany and to analyze hospitalization and treatment patterns. Patients and Methods Based on a German claims database with 4.9 million enrollees, a retrospective longitudinal analysis covering a 6-year period between 2013 and 2018 was conducted. Patients with allo-HCT in 2014 or 2015 (index date) and no record of transplantation or documentation of GvHD 365 days prior to index were included. Patients who subsequently developed a cGVHD were compared with those who did not develop a cGVHD within 3 years after index date. cGVHD cases were identified based on documented International Classification of Diseases, Tenth Revision (ICD-10) diagnosis and treatment algorithms. Since the onset of cGvHD is defined at 100 days after allo-HCT, only those alive beyond day 100 were considered in the survival analysis. Patients who did not survive the first 100 days after allo-HCT were censored to prevent a selection bias due to early mortality within patients without GvHD. Survival rates were plotted using the Kaplan-Meier estimator. The number of hospitalizations and average lengths of stay as well as treatment patterns were descriptively examined. Results Overall, 165 cGvHD patients were identified and compared with 43 patients without cGVHD. Short-term survival rates were better for patients with cGvHD; the 6-month survival probability was 95.8% for patients with cGVHD and 83.7% for patients without cGVHD. However, long-term survival was better in patients without GvHD; The 30-month survival probability was 65.5% for patients with cGVHD and 76.7% for patients without cGVHD. While overall 90% of cGvHD patients were hospitalized at least once, the share was only half for patients without GvHD (44%). 78.2% of patients with cGVHD received corticosteroids in combination with other predefined immunosuppressants. Conclusion Findings from this study reveal a high disease burden associated with cGvHD. This underlines the high medical need for new interventional strategies to improve survival and morbidity after allo-HCT.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Scheid, Christof UNSPECIFIED UNSPECIFIED UNSPECIFIED Kudernatsch, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Eckart, Marie UNSPECIFIED UNSPECIFIED UNSPECIFIED Feig, Chiara UNSPECIFIED UNSPECIFIED UNSPECIFIED Straub, Vincent UNSPECIFIED UNSPECIFIED UNSPECIFIED Libutzki, Berit UNSPECIFIED UNSPECIFIED UNSPECIFIED Mahlich, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-684267
DOI:	10.1007/s40801-022-00320-8
Journal or Publication Title:	Drugs-Real World Outcomes
Volume:	9
Number:	4
Page Range:	S. 577 - 589
Date:	2022
Publisher:	SPRINGERNATURE
Place of Publication:	LONDON
ISSN:	2198-9788
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SURVIVAL; RELAPSE Multiple languages Pharmacology & Pharmacy Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68426