Real-World Assessment of Myelodysplastic Syndrome: Japanese Claims Data Analysis

Figures & data

Table 1. Myelodysplastic syndrome-related treatments considered.

Generic name
Azacitidine
Lenalidomide
Erythropoiesis-stimulating agent:
– Darbepoetin
G-CSF
Allogeneic hematopoietic stem cell transplantation
Transfusion
Chemotherapy:
– Aclarubicin	– Dacarbazine
– Capecitabine	– Doxorubicin
– Carmustine	– Hydroxycarbamide
– Chlorambucil	– Paclitaxel protein-bound
– Cytarabine	– Vinorelbine

Figure 1. Patient selection for inclusion in analysis.

ICD-10: International Classification of Diseases 10th Revision; MDS: Myelodysplastic syndrome.

Table 2. Patient baseline characteristics overall and by treatment category.

Characteristics	Overall	Transfusion	ESA	ESA + transfusion	AZA	AZA + transfusion	Others	p-value
Population (n)	5981	2844	294	252	288	703	1600
Age								<0.0001
– Median (Q1, Q3)	75.0 (67.0, 82.0)	78.0 (69.0, 84.0)	79.0 (73.0, 84.0)	79.0 (73.0, 85.0)	71.0 (66.0, 77.0)	73.0 (65.0, 78.0)	73.0 (64.0, 79.0)
Age group (years; n, %)								<0.0001
– 0–19	32 (0.5)	23 (0.8)	0 (0)	0 (0)	3 (1)	0 (0)	6 (0.4)
– 20–59	674 (11.3)	292 (10.3)	21 (7.1)	14 (5.6)	28 (9.7)	75 (10.7)	244 (15.3)
– 60–79	3226 (53.9)	1313 (46.2)	135 (45.9)	114 (45.2)	211 (73.3)	490 (69.7)	963 (60.2)
– 80+	2049 (34.3)	1216 (42.8)	138 (46.9)	124 (49.2)	46 (16)	138 (19.6)	387 (24.2)
Gender (n, %)
– Female	2261 (37.8)	1184 (41.6)	138 (46.9)	80 (31.7)	80 (27.8)	198 (28.2)	581 (36.3)	<0.0001
– Male	3720 (62.2)	1660 (58.4)	156 (53.1)	172 (68.3)	208 (72.2)	505 (71.8)	1019 (63.7)
Baseline CCI during look-back period (including index date) (n, %)
– Mean (SD)	2.5 (2.3)	2.5 (2.3)	3.2 (2.4)	2.6 (2.3)	1.9 (1.9)	2.0 (2.0)	2.7 (2.4)	<0.0001
– Median (Q1, Q3)	2.0 (0.0, 4.0)	2.0 (0, 4.0)	3.0 (1.0, 5.0)	2.0 (1.0, 4.0)	2.0 (0, 3.0)	2.0 (0, 3.0)	2.0 (1.0, 4.0)
– 0–2	3633 (60.8)	1735 (61.0)	137 (46.6)	130 (51.6)	209 (72.6)	486 (69.1)	936 (58.5)
– 3–5	1675 (28.0)	777 (27.3)	107 (36.4)	95 (37.7)	64 (22.2)	176 (25.0)	456 (28.5)
– 6+	673 (11.3)	332 (11.7)	50 (17.0)	27 (10.7)	15 (5.2)	41 (5.8)	208 (13)
Follow-up time (days)^†
– Mean (SD)	546.3 (569.8)	584.8 (610.3)	752.9 (532.5)	593.0 (479.2)	518.8 (517.7)	427.6 (448.2)	489.6 (554.3)	<0.0001

Patients were categorized by the treatment regimen received in their first line of therapy.

† Follow-up time was from index date until death or last patient record with 12-month look-back period.

AZA: Azacitidine; CCI: Charlson comorbidity index; ESA: Erythropoiesis-stimulating agents; SD: Standard deviation.

Figure 2. Sankey diagram of treatment patterns by line of therapy.

Patients were categorized by treatment regimen received in the 1L of therapy.

AZA: Azacitidine; ESA: Erythropoiesis-stimulating agents; MDS: Myelodysplastic syndromes.

Figure 3. Medical costs up to 3 years by regimen group.

(A) Total costs and department costs. (B) Treatment-related costs. Cost in US$.

Error bars indicate 95% Cl. Patients were categorized by treatment regimen received in the 1L of therapy.

Allo-HSCT: Allogenic hematopoietic stem cell transplant; AZA: Azacitidine; ESA: Erythropoiesis-stimulating agents; ICT: Iron chelation therapy; ICU: Intensive care unit; MDS: Myelodysplastic syndromes.

Figure 4. Total costs during different periods from the start of follow-up by regimen group.

Cost in US$.

Error bars indicate 95% Cl. Patients are categorized by treatment regimen received in the 1L therapy.

AZA: Azactidine; ESA: Erythropoiesis-stimulating agents.

Figure 5. Average number of healthcare resource use over 3 years.

AZA: Azacitidine; ER: Emergency room; ESA: Erythropoiesis-stimulating agents; ICT: Iron chelation therapy; ICU: Intensive cure unit.