Treatment patterns in adults with immune thrombocytopenia before, during and after use of thrombopoietin receptor agonists: a longitudinal prescription database study from Germany

Figures & data

Figure 1. Study flow diagram. ITP, immune thrombocytopenia; TPO-RA, thrombopoietin receptor agonist.

Table 1. Demographic parameters of included participants.

Parameter	Romiplostim(n=801)	Eltrombopag(n=2752)	Overall TPO-RA(n=3553)
Sex, n (%) Male Female Unknown	362 (45.2) 362 (45.2) 77 (9.6)	1156 (42.0) 1274 (46.3) 322 (11.7)	1518 (42.7) 1636 (46.0) 399 (11.2)
Median (min, max) index age, years	63 (18, 97)	64 (18, 99)	64 (18, 99)
Index age category, n (%) 18–60 years >60 years	361 (45.1) 440 (54.9)	1183 (43.0) 1569 (57.0)	1544 (43.5) 2009 (56.5)

Notes: Max, maximum; min, minimum; TPO-RA, thrombopoietin receptor agonist.

Figure 2. Cumulative incidence of (A) all patients treated with corticosteroids at any point during the 18 months prior to the index date and (B) all patients treated with immunoglobulin at any point during the 18 months prior to the index date. Gray lines represent 95% confidence intervals.

Table 2. Corticosteroid use before, during and after TPO-RA treatment.

	Before TPO-RA treatment(n=3553)	During TPO-RA treatment(n=3553)	After TPO-RA treatment(n=1093)
Duration of observation period* (months)	18	Mean 12.6 Median 9.3 (range 1.0–42.0)	Mean 16.1 Median 13.6 (range 5.9–40.0)
Total corticosteroid dose n Mean (SD), mg Median (min, max), mg	2289 3327.8 (3165.0) 2521.9 (4.9, 39,702.3)	1541 3045.7 (3311.5) 2000.0 (8.9, 32,912.0)	395 3486.9 (3699.5) 2277.8 (14.3, 31,323.2)
Corticosteroid duration n Mean (SD), weeks Median (min, max), weeks	2289 24.1 (23.6) 15.0 (0.14, 77.1)	1541 27.9 (28.7) 18.4 (0.14, 178.1)	395 39.3 (31.7) 31.9 (0.14, 158.3)
Patients receiving corticosteroids, n (%)	2289 (64.4)	1541 (43.4)	395 (36.1)
Type of corticosteroid medication,^† n (%) Prednisone Prednisolone Methylprednisolone Dexamethasone	n=2289 416 (18.2) 1726 (75.4) 47 (2.1) 556 (24.3)	n=1541 291 (18.9) 1231 (79.9) 32 (2.1) 332 (21.5)	n=395 74 (18.7) 307 (77.7) 12 (3.0) 88 (22.3)

Notes: Max, maximum; min, minimum; SD, standard deviation; TPO-RA, thrombopoietin receptor agonist.

*Data for the duration of the TPO-RA treatment and post–TPO-RA treatment phases were generated post hoc using arithmetic statistics. Since these are left censored (i.e. some values represent underestimates of the true values), they are specific to the timespans applied here. In particular, the arithmetic median TPO-RA phase does not relate to the more accurate median shown by the equivalent Kaplan-Meier curves (Figure 4).

^† Patients could receive more than one corticosteroid medication.

Figure 3. Proportion of patients receiving (A) corticosteroids on each day prior to the index date and (B) immunoglobulins on each day prior to the index date. Gray lines represent 95% confidence intervals.

Figure 4. Persistence on thrombopoietin receptor agonists (TPO-RAs).

Figure 5. Proportion of patients receiving (A) corticosteroids on each day after the index date during the thrombopoietin receptor agonist (TPO-RA) treatment period and (B) immunoglobulins on each day after the index date during the TPO-RA treatment period. Gray lines represent 95% confidence intervals.

Figure 6. Proportion of patients receiving (A) corticosteroids on each day after thrombopoietin receptor agonist (TPO-RA) treatment ceased and (B) immunoglobulins on each day after TPO-RA treatment ceased. Gray lines represent 95% confidence intervals.

Data availability statement

The data that have been used in this study are confidential.