Deferasirox therapy is associated with reduced mortality risk in a medicare population with myelodysplastic syndromes

Amer M. Zeidan; Franklin Hendrick; Erika Friedmann; Maria R. Baer; Steven D. Gore; Medha Sasane; Carole Paley; Amy J. Davidoff

doi:10.2217/cer.15.20

Deferasirox therapy is associated with reduced mortality risk in a medicare population with myelodysplastic syndromes

Amer M. Zeidan, Franklin Hendrick, Erika Friedmann, Maria R. Baer, Steven D. Gore, Medha Sasane, Carole Paley, Amy J. Davidoff

School of Medicine

Research output: Contribution to journal › Article › peer-review

25 Scopus citations

Abstract

Aims: Iron overload adversely affects patients with myelodysplastic syndromes (MDS), but benefits of iron chelation therapy have not been clearly demonstrated. We examined the association between deferasirox (DFX) therapy and mortality in transfusion-receiving Medicare patients. Patients & methods: MDS patients from 2005 to 2008 were identified using ICD-9 codes from 100% Medicare claims. Patients receiving ≥20 blood units were observed until death or end of study. Marginal structural models were used for estimation. Results: 3926 patients (10.1% used DFX) were observed for a mean of 48.8 weeks. Each incremental week of DFX was associated with a significant reduction in mortality risk (hazard ratio [HR]: 0.989; 95% CI: 0.983-0.996; p = 0.001). Conclusion: DFX therapy is associated with a reduced mortality risk among older MDS patients who received a minimum transfusion threshold.

Original language	English (US)
Pages (from-to)	327-340
Number of pages	14
Journal	Journal of Comparative Effectiveness Research
Volume	4
Issue number	4
DOIs	https://doi.org/10.2217/cer.15.20
State	Published - Aug 1 2015

Keywords

deferasirox
iron chelation therapy
iron overload
mortality
myelodysplastic syndromes

ASJC Scopus subject areas

Health Policy

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10.2217/cer.15.20

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title = "Deferasirox therapy is associated with reduced mortality risk in a medicare population with myelodysplastic syndromes",

abstract = "Aims: Iron overload adversely affects patients with myelodysplastic syndromes (MDS), but benefits of iron chelation therapy have not been clearly demonstrated. We examined the association between deferasirox (DFX) therapy and mortality in transfusion-receiving Medicare patients. Patients & methods: MDS patients from 2005 to 2008 were identified using ICD-9 codes from 100% Medicare claims. Patients receiving ≥20 blood units were observed until death or end of study. Marginal structural models were used for estimation. Results: 3926 patients (10.1% used DFX) were observed for a mean of 48.8 weeks. Each incremental week of DFX was associated with a significant reduction in mortality risk (hazard ratio [HR]: 0.989; 95% CI: 0.983-0.996; p = 0.001). Conclusion: DFX therapy is associated with a reduced mortality risk among older MDS patients who received a minimum transfusion threshold.",

keywords = "deferasirox, iron chelation therapy, iron overload, mortality, myelodysplastic syndromes",

author = "Zeidan, {Amer M.} and Franklin Hendrick and Erika Friedmann and Baer, {Maria R.} and Gore, {Steven D.} and Medha Sasane and Carole Paley and Davidoff, {Amy J.}",

note = "Publisher Copyright: {\textcopyright} 2015 Future Medicine Ltd.",

year = "2015",

month = aug,

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doi = "10.2217/cer.15.20",

language = "English (US)",

volume = "4",

pages = "327--340",

journal = "Journal of Comparative Effectiveness Research",

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T1 - Deferasirox therapy is associated with reduced mortality risk in a medicare population with myelodysplastic syndromes

AU - Zeidan, Amer M.

AU - Hendrick, Franklin

AU - Friedmann, Erika

AU - Baer, Maria R.

AU - Gore, Steven D.

AU - Sasane, Medha

AU - Paley, Carole

AU - Davidoff, Amy J.

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Aims: Iron overload adversely affects patients with myelodysplastic syndromes (MDS), but benefits of iron chelation therapy have not been clearly demonstrated. We examined the association between deferasirox (DFX) therapy and mortality in transfusion-receiving Medicare patients. Patients & methods: MDS patients from 2005 to 2008 were identified using ICD-9 codes from 100% Medicare claims. Patients receiving ≥20 blood units were observed until death or end of study. Marginal structural models were used for estimation. Results: 3926 patients (10.1% used DFX) were observed for a mean of 48.8 weeks. Each incremental week of DFX was associated with a significant reduction in mortality risk (hazard ratio [HR]: 0.989; 95% CI: 0.983-0.996; p = 0.001). Conclusion: DFX therapy is associated with a reduced mortality risk among older MDS patients who received a minimum transfusion threshold.

AB - Aims: Iron overload adversely affects patients with myelodysplastic syndromes (MDS), but benefits of iron chelation therapy have not been clearly demonstrated. We examined the association between deferasirox (DFX) therapy and mortality in transfusion-receiving Medicare patients. Patients & methods: MDS patients from 2005 to 2008 were identified using ICD-9 codes from 100% Medicare claims. Patients receiving ≥20 blood units were observed until death or end of study. Marginal structural models were used for estimation. Results: 3926 patients (10.1% used DFX) were observed for a mean of 48.8 weeks. Each incremental week of DFX was associated with a significant reduction in mortality risk (hazard ratio [HR]: 0.989; 95% CI: 0.983-0.996; p = 0.001). Conclusion: DFX therapy is associated with a reduced mortality risk among older MDS patients who received a minimum transfusion threshold.

KW - deferasirox

KW - iron chelation therapy

KW - iron overload

KW - mortality

KW - myelodysplastic syndromes

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Deferasirox therapy is associated with reduced mortality risk in a medicare population with myelodysplastic syndromes

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