NDLI: Comparative effectiveness of filgrastim, pegfilgrastim, and sargramostim as prophylaxis against hospitalization for neutropenic complications in patients with cancer receiving chemotherapy.

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Comparative effectiveness of filgrastim, pegfilgrastim, and sargramostim as prophylaxis against hospitalization for neutropenic complications in patients with cancer receiving chemotherapy.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Weycker, Derek Malin, Jennifer Barron, Rich Edelsberg, John Kartashov, Alex Oster, Gerry
Description	Country affiliation: United States Author Affiliation: Weycker D ( Policy Analysis Inc., Four Davis Court, Brookline, MA 02445, USA. dweycker@pai2.com)
Abstract	BACKGROUND: Comparative effectiveness of filgrastim, pegfilgrastim, and sargramostim in preventing hospitalization for febrile neutropenia (FN) during myelosuppressive chemotherapy has not been well characterized and is an important clinical question in oncology. METHODS: This study used a retrospective cohort design and US healthcare claims data. Source population included patients with solid tumors receiving filgrastim, pegfilgrastim, or sargramostim during their first observed course of chemotherapy between July 2001 and June 2007. For each patient, every unique chemotherapy cycle during the course was identified, along with each cycle in which filgrastim, pegfilgrastim, or sargramostim was administered by the fifth day of the cycle (ie, as prophylaxis). Risks of hospitalization for neutropenic complications (broad definition: admission with a diagnosis of neutropenia, fever, or infection; narrow definition: admission with a diagnosis of neutropenia) and for any reason were examined on a cycle-specific basis during all the cycles in which colony-stimulating factor prophylaxis was administered. Unadjusted and adjusted odds ratios (ORs) for hospitalization were estimated. RESULTS: Risk (unadjusted) of hospitalization for neutropenic complications (narrow definition) was 2.1% for filgrastim prophylaxis (n=8286), 1.1% for pegfilgrastim prophylaxis (n=67,247), and 2.5% for sargramostim prophylaxis (n=1736). Corresponding risks of hospitalization based on the broad definition were 4.0%, 2.6%, and 5.1%. Risks of all-cause hospitalization were 7.9%, 5.3%, and 9.6%, respectively. Adjusted odds of hospitalization were significantly higher for filgrastim [OR (range across the 3 alternative measures of hospitalization): 1.58-1.79; P<0.001] and sargramostim (OR: 1.89-2.68; P<0.001) versus pegfilgrastim. CONCLUSIONS: Risk of hospitalization for neutropenic complications during cancer chemotherapy is lower with pegfilgrastim prophylaxis than with filgrastim or sargramostim prophylaxis.
File Format	HTM / HTML
ISSN	02773732
Issue Number	3
Volume Number	35
e-ISSN	1537453X
Journal	American Journal of Clinical Oncology
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2012-06-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Oncology Antineoplastic Agents Adverse Effects Granulocyte Colony-stimulating Factor Therapeutic Use Granulocyte-macrophage Colony-stimulating Factor Hospitalization Statistics & Numerical Data Neoplasms Drug Therapy Neutropenia Chemically Induced Adolescent Adult Aged Aged, 80 And Over Female Filgrastim Follow-up Studies Humans Immunologic Factors Male Middle Aged Prognosis Recombinant Proteins Retrospective Studies Young Adult Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Cancer Research Oncology

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Comparative effectiveness of pegfilgrastim, filgrastim, and sargramostim prophylaxis for neutropenia-related hospitalization: two US retrospective claims analyses.

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Comparative effectiveness of filgrastim, pegfilgrastim, and sargramostim as prophylaxis against hospitalization for neutropenic complications in patients with cancer receiving chemotherapy.

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