Sociodemographic associations with uptake of novel therapies for acute myeloid leukemia.
Sociodemographic associations with uptake of novel therapies for acute myeloid leukemia.
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DOI：
10.1038/s41408-023-00964-x
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发表时间：
2023-12-21
影响因子：
12.8
通讯作者：
Abel, Gregory A.
中科院分区：
文献类型：
--
作者：
Hantel, Andrew;Cernik, Colin;Uno, Hajime;Walsh, Thomas P.;Calip, Gregory S.;DeAngelo, Daniel J.;Lathan, Christopher S.;Abel, Gregory A.
已知在非癌症环境中，社会经济地位较低（SES）、有色人种（POC）和老年人的患者不公平地接受新疗法（NT）。急性髓性白血病（AML）中NT摄取的公平性尚不清楚。我们对美国全国Flatiron HealthTM电子健康记录衍生的去识别数据库进行了一项回顾性队列研究（1/2014-8/2022）。我们使用发病率比（IRR）估计了AML NT治疗的社会人口学相关性。比值比（OR）评估了社区站点维奈托克（最常见的NT）接收的差异以及站点特征和NT采用之间的差异。在8081例患者（139家临床试验机构）中，3102例（38%）接受了NT。NT的使用逐年增加（IRR 1.14，95%置信区间[1.07，1.22]）。非西班牙裔白人和POC之间的NT接受情况相似（IRR 1.03，[0.91，1.17]），并且随着年龄的增长（IRR 1.02 [0.97，1.07]）。在社区研究中心，非西班牙裔白人接受维奈托克的可能性较低（OR 0.77 [0.66，0.91]）;年龄较大（OR 1.05 [1.04，1.05]）和较高的地区水平SES与接受维奈托克相关（OR 1.23 [1.05，1.43]）。早期采用NT的研究中心有更多的处方医生（OR 1.25 [1.13，1.43]）和更高的SES分层患者（OR 2.81 [1.08，7.66]）。SES观察到AML NT摄取的不平等;对于维奈托克，差异摄取反映了其在老年人和合并症患者中的标签适应症。
Inequitable uptake of novel therapies (NT) in non-cancer settings are known for patients with lower socioeconomic status (SES), People of Color (POC), and older adults. NT uptake equity in acute myeloid leukemia (AML) is not well known. We performed a retrospective cohort study (1/2014-8/2022) of the United States nationwide Flatiron HealthTM electronic health record-derived, de-identified database. We estimated sociodemographic associations with AML NT receipt using incidence rate ratios (IRR). Odds ratios (OR) assessed differences in venetoclax (the most common NT) receipt at community sites and between site characteristics and NT adoption. Of 8081 patients (139 sites), 3102 (38%) received a NT. NT use increased annually (IRR 1.14, 95% confidence interval [1.07, 1.22]). NT receipt was similar between Non-Hispanic-Whites and POC (IRR 1.03, [0.91, 1.17]) and as age increased (IRR 1.02 [0.97, 1.07]). At community sites, Non-Hispanic-Whites were less likely to receive venetoclax (OR 0.77 [0.66, 0.91]); older age (OR 1.05 [1.04, 1.05]) and higher area-level SES were associated with venetoclax receipt (OR 1.23 [1.05, 1.43]). Early NT adopting sites had more prescribing physicians (OR 1.25 [1.13, 1.43]) and higher SES strata patients (OR 2.81 [1.08, 7.66]). Inequities in AML NT uptake were seen by SES; for venetoclax, differential uptake reflects its label indication for older adults and those with comorbidities.
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影响因子：
28.2
作者：
Bhatnagar B;Kohlschmidt J;Mrózek K;Zhao Q;Fisher JL;Nicolet D;Walker CJ;Mims AS;Oakes C;Giacopelli B;Orwick S;Boateng I;Blachly JS;Maharry SE;Carroll AJ;Powell BL;Kolitz JE;Stone RM;Byrd JC;Paskett ED;de la Chapelle A;Garzon R;Eisfeld AK
通讯作者：
Eisfeld AK
影响因子：
7.5
作者：
Hantel A;Luskin MR;Garcia JS;Stock W;DeAngelo DJ;Abel GA
通讯作者：
Abel GA
影响因子：
20.3
作者：
Abraham, Ivy Elizabeth;Rauscher, Garth H.;Khan, Irum
通讯作者：
Khan, Irum
DOI：
10.1097/coc.0b013e3181dea934
发表时间：
2011-06-01
影响因子：
2.6
作者：
Byrne, Margaret M.;Halman, L. Jill;Cheung, Michael C.
通讯作者：
Cheung, Michael C.
影响因子：
28.4
作者：
O'Connor, Jeremy M.;Fessele, Kristen L.;Gross, Cary P.
通讯作者：
Gross, Cary P.