Treatment patterns and outcomes in patients with myelodysplastic syndromes treated with hypomethylating agents: a SEER-Medicare analysis

Abstract

To describe real-world treatment patterns and outcomes among adult patients with myelodysplastic syndromes (MDS) treated with hypomethylating agents (HMA), patients were identified in the SEER-Medicare database (01/2006–12/2016); 3,046 patients with MDS treated with HMA were included. An algorithm was developed to categorize patients into MDS risk groups: the majority of patients were classified as Higher-risk (70.9%), 8.0% as Intermediate-risk, and 21.1% as Unknown-risk. Overall, 77.4% of patients initiated azacitidine and 22.6% decitabine; they received an average of 5.1 index-HMA cycles, of which 90.9% were complete with a median cycle duration of 28 days. Median survival was 11.6, 18.4, and 19.1 months for the Higher-risk, Intermediate-risk, and Unknown-risk groups, respectively. Median time-to-AML transformation was 19.3 months for the Higher-risk group and 50.4 months for the Intermediate-risk group (not reached for Unknown-risk). Data highlight the unmet medical needs of patients with MDS treated with HMA, particularly for the Higher-risk MDS group.

Keywords:

• Myelodysplastic syndromes
• hypomethylating agents
• claims database
• treatment patterns
• overall survival
• acute myeloid leukemia transformation

Acknowledgements

We would like to thank Carmine Rossi, PhD, an employee of Analysis Group, Inc., for his contribution during the course of this research. Medical writing support was provided by a professional medical writer, Loraine Georgy, PhD, an employee of Analysis Group, Inc., which has received funding from Novartis Pharmaceuticals Corporation.

Disclosure statement

EMS provided paid consulting services to Novartis Pharmaceuticals Corporation. IS and XC are employees and stockholders of Novartis Pharmaceuticals Corporation. GB was an employee and stockholder of Novartis Pharmaceuticals Cooperation at the time the study was conducted. DLV, SS, AG, and EQW are employees of Analysis Group, Inc., a consulting company that has provided paid consulting services to Novartis Pharmaceuticals Corporation.

Additional information

Funding

This study was sponsored by Novartis Pharmaceuticals Corporation. The study sponsor was involved in several aspects of the research including the study design, the interpretation of data, the writing of the manuscript, and the decision to submit the manuscript for publication.