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

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)327-340
Number of pages14
JournalJournal of Comparative Effectiveness Research
Volume4
Issue number4
DOIs
StatePublished - Aug 1 2015
Externally publishedYes

Fingerprint

Myelodysplastic Syndromes
Medicare
Mortality
Population
International Classification of Diseases
Therapeutics
Chelation Therapy
Iron Overload
Structural Models
deferasirox
Iron
Odds Ratio

Keywords

  • deferasirox
  • iron chelation therapy
  • iron overload
  • mortality
  • myelodysplastic syndromes

ASJC Scopus subject areas

  • Health Policy

Cite this

Deferasirox therapy is associated with reduced mortality risk in a medicare population with myelodysplastic syndromes. / Zeidan, Amer M.; Hendrick, Franklin; Friedmann, Erika; Baer, Maria R.; Gore, Steven D.; Sasane, Medha; Paley, Carole; Davidoff, Amy J.

In: Journal of Comparative Effectiveness Research, Vol. 4, No. 4, 01.08.2015, p. 327-340.

Research output: Contribution to journalArticle

Zeidan, AM, Hendrick, F, Friedmann, E, Baer, MR, Gore, SD, Sasane, M, Paley, C & Davidoff, AJ 2015, 'Deferasirox therapy is associated with reduced mortality risk in a medicare population with myelodysplastic syndromes', Journal of Comparative Effectiveness Research, vol. 4, no. 4, pp. 327-340. https://doi.org/10.2217/cer.15.20
Zeidan, Amer M. ; Hendrick, Franklin ; Friedmann, Erika ; Baer, Maria R. ; Gore, Steven D. ; Sasane, Medha ; Paley, Carole ; Davidoff, Amy J. / Deferasirox therapy is associated with reduced mortality risk in a medicare population with myelodysplastic syndromes. In: Journal of Comparative Effectiveness Research. 2015 ; Vol. 4, No. 4. pp. 327-340.
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AU - Gore, Steven D.

AU - Sasane, Medha

AU - Paley, Carole

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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.

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