Abstract Number: PB0819
Meeting: ISTH 2021 Congress
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.
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.
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