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Survival outcomes in myelofibrosis patients treated with ruxolitinib: A population‐based cohort study in Sweden and Norway
Author(s) -
Schain Frida,
Vago Emese,
Song Ci,
He Jianming,
Liwing Johan,
Löfgren Christina,
Björkholm Magnus
Publication year - 2019
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13330
Subject(s) - ruxolitinib , medicine , myelofibrosis , discontinuation , population , cohort , survival analysis , confidence interval , pediatrics , surgery , bone marrow , environmental health
Objective To estimate survival in Swedish and Norwegian myelofibrosis (MF) patients who received ruxolitinib. Methods Swedish and Norwegian patients with MF diagnosis in the National Cancer Registries (Sweden: 2001‐2015; Norway: 2002‐2016) and ≥1 record of ruxolitinib in the Prescribed Drug Registries (2013‐2017) were included. Patients were followed from ruxolitinib initiation until death or end of follow‐up; those who discontinued ruxolitinib were followed from ruxolitinib discontinuation. Relative survival (RS) and excess mortality rate ratios (EMRRs) were calculated vs a matched general population. Average loss in life expectancy (LEL) was predicted using flexible parametric models. Results Among patients who initiated ruxolitinib (n = 190), 1‐ and 4‐year RS were 0.80 (95% confidence interval [CI]: 0.74, 0.86) and 0.52 (95% CI: 0.42, 0.64), respectively, and LEL was 11 years. EMRR was greater in patients aged >70 vs <60 years (3.16; 95% CI: 1.34‐7.40). Among patients who discontinued ruxolitinib (n = 71), median RS was 16.0 months (95% CI: 6.3, NE), and LEL was 12 years. After ruxolitinib treatment discontinuation, Swedish patients (n = 37) received glucocorticoids, hydroxyurea, busulfan, danazol and lenalidomide. Conclusion Swedish and Norwegian MF patients who discontinued ruxolitinib had dismal survival outcomes and limited subsequent treatment options, highlighting the need for improved therapies.