Abstract Number: PB0819
Meeting: ISTH 2021 Congress
Theme: Platelet Disorders, von Willebrand Disease and Thrombotic Microangiopathies » Acquired Thrombocytopenias
Background: The recent ASH Guidelines and International Consensus Report for the management of ITP suggest consideration of TPO-RAs as subsequent therapy following an insufficient response to first-line treatments, especially if seeking a durable platelet response.
Aims: To understand length of therapy (LOT) and persistence (PER) of treatment in adult ITP patients in US, treated with an FDA-approved TPO-RA (avatrombopag (AVA), eltrombopag (ELT) or romiplostim (ROMI).
Methods: Inclusion in the analyses required a D69.3 or D69.49 ICD-10 diagnostic code for ITP and ≥ 1 first-initiated claim for ELT or ROMI during the 2019 calendar year from the Symphony Health Claims Database and from a closed system of specialty pharmacies (CVS, Accredo, Biologics, Kroger, PharmaCord, Panther) from August 2019 through December 2019 for AVA.
LOT for each TPO-RA was determined by calculating the time between the first claim/shipment date and the last claim/shipment date while adding on the number of days of supply provided in the last claim/shipment.
PER for each TPO-RA was determined by claims occurring in specific months. Unlike LOT, PER did not add the number of days of supply to the last evaluable claim/shipment.
Results: LOT and PER for each TPO-RA are shown below (Table 1). LOT was highest in AVA patients, regardless of whether a conservative single claim/shipment or ≥ 2 claims/shipments were used. PER for each individual month reached was highest for AVA, with the median AVA patient reaching 10 months of treatment.
Length of Therapy (LOT) and Persistence of Treatment (PER) for TPO-RAs in Adult ITP
Conclusions: AVA demonstrated a greater length of treatment and higher rates of persistence than other TPO-RAs, possibly due to a variety of variables: route of administration, convenience, patient preference, efficacy, side effects, insurance coverage. These results should be interpreted with caution. Claims data using matched methodologies were utilized; however, due to AVA’s commercial availability occurring in July 2019, slightly different time frames were evaluated.
To cite this abstract in AMA style:
Vredenburg M, Kolodny S, Wojdyla M, Boyer H, Darden T. Length of Thrombopoietin Receptor Agonist (TPO-RA) Treatment and Persistence in Immune Thrombocytopenia (ITP): Real World United States Claims Analyses [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/length-of-thrombopoietin-receptor-agonist-tpo-ra-treatment-and-persistence-in-immune-thrombocytopenia-itp-real-world-united-states-claims-analyses/. Accessed November 30, 2023.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/length-of-thrombopoietin-receptor-agonist-tpo-ra-treatment-and-persistence-in-immune-thrombocytopenia-itp-real-world-united-states-claims-analyses/