Real-World Use and Acceptance of Rituximab Biosimilars in Non-Hodgkin Lymphoma in an Oncologist Network in Germany

Figures & data

Figure 1. Distribution of patients included in the database according to International Classification of Diseases code indication.

DLBCL: Diffuse large B-cell lymphoma; FL: Follicular lymphoma; MCL: Mantle cell lymphoma; MZL: Marginal zone lymphoma; NHL: Non-Hodgkin lymphoma.

Table 1. Patient demographics.

Characteristics	All patients (n = 1741)	Patients with NHL (n = 1241)	Patients with CLL (n = 500)
Age (years)
11–20	5 (0.3)	5 (0.4)	0 (0.0)
21–30	11 (0.6)	11 (0.9)	0 (0.0)
31–40	19 (1.1)	18 (1.5)	1 (0.2)
41–50	93 (5.3)	80 (6.4)	13 (2.6)
51–60	277 (15.9)	209 (16.8)	68 (13.6)
61–70	387 (22.2)	279 (22.5)	107 (21.4)
71–80	632 (36.3)	424 (34.2)	207 (41.4)
81–90	307 (17.6)	208 (16.8)	101 (20.2)
≥91	10 (0.6)	7 (0.6)	3 (0.6)
Sex
Male	992 (57.0)	692 (55.8)	300 (60.0)
Female	749 (43.0)	549 (44.2)	200 (40.0)

Data represented as n (%).

CLL: Chronic lymphocytic leukemia; NHL: Non-Hodgkin lymphoma.

Figure 2. Rituximab use by product and therapeutic protocol.

BR: Bendamustine plus rituximab; FCR: Fludarabine plus cyclophosphamide and rituximab; n/s: Not specified; R-CHOP: Rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisolone; SC: Subcutaneous.

Table 2. Most frequent rituximab protocols identified in the Onkotrakt database.

Treatment protocol	Patients (n)
Most frequent (>20 patients)
Bendamustine + rituximab (BR)	426
Rituximab + cyclophosphamide + doxorubicin + vincristine + prednisolone (R-CHOP)	337
Rituximab maintenance	307
Rituximab monotherapy	223
BR + methotrexate	43
Fludarabine + cyclophosphamide + rituximab	38
R-CHOP + methotrexate	27
Methotrexate + rituximab	23
Rituximab + cyclophosphamide + doxorubicin + vincristine + etoposide + prednisolone	22
Chlorambucil + rituximab	20

BR: Bendamustine plus rituximab; R-CHOP: Rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisolone.

Figure 3. Rituximab use.

(A) indication and (B) line of therapy.

*Marginal zone lymphoma, mantle cell lymphoma, ‘other nonfollicular lymphoma’, NK/T cell lymphoma, ‘unspecified NHL’.

CLL: Chronic lymphocytic leukemia; DLBCL: Diffuse large B-cell lymphoma; FL: Follicular lymphoma; NHL: Non-Hodgkin lymphoma; NK/T cell: Natural killer/T cell; SC: Subcutaneous.

Figure 4. Differences in number of cycles administered for each rituximab formulation between 2017 and 2019.

CLL: Chronic lymphocytic leukemia; DLBCL: Diffuse large B-cell lymphoma; SC: Subcutaneous.

Figure 5. Switching data between reference and biosimilar or between biosimilar rituximab medicines.

SC: Subcutaneous.

Figure 6. Time course of rituximab prescriptions.

(A) FL, (B) DLBCL, (C) CLL, (D) Other (unspecified non-Follicular lymphoma, Marginal zone lymphoma, Mantle cell lymphoma, Natural killer/T cell cell lymphoma). Data presented as polynomial trend lines of the percentage prescriptions per month.

CLL: Chronic lymphocytic leukemia; DLBCL: Diffuse large B-cell lymphoma; NHL; SC: Subcutaneous.