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Cytoreductive treatment patterns among US veterans with polycythemia vera

BACKGROUND: Polycythemia vera (PV) is a myeloproliferative neoplasm associated with increased thrombotic and cardiovascular risk, which are key contributors to patient morbidity and mortality. The Veterans Health Administration (VHA) is the largest integrative health network in the United States. Av...

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Autores principales: Parasuraman, Shreekant, Yu, Jingbo, Paranagama, Dilan, Shrestha, Sulena, Wang, Li, Baser, Onur, Scherber, Robyn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5935975/
https://www.ncbi.nlm.nih.gov/pubmed/29728092
http://dx.doi.org/10.1186/s12885-018-4422-6
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author Parasuraman, Shreekant
Yu, Jingbo
Paranagama, Dilan
Shrestha, Sulena
Wang, Li
Baser, Onur
Scherber, Robyn
author_facet Parasuraman, Shreekant
Yu, Jingbo
Paranagama, Dilan
Shrestha, Sulena
Wang, Li
Baser, Onur
Scherber, Robyn
author_sort Parasuraman, Shreekant
collection PubMed
description BACKGROUND: Polycythemia vera (PV) is a myeloproliferative neoplasm associated with increased thrombotic and cardiovascular risk, which are key contributors to patient morbidity and mortality. The Veterans Health Administration (VHA) is the largest integrative health network in the United States. Available data concerning patients with PV in this population are limited. METHODS: This retrospective observational study evaluated the characteristics, management, and outcomes of patients with PV in the VHA Medical SAS® Dataset (October 1, 2005, to September 30, 2012). Inclusion criteria were ≥ 2 claims for PV (ie, PV diagnostic code was recorded) ≥30 days apart during the identification period, age ≥ 18 years, and continuous health plan enrollment from ≥12 months before the index date until the end of follow-up. All data were analyzed using descriptive statistics. RESULTS: The analysis included 7718 patients (median age, 64 years; male, 98%; white, 64%). The most common comorbidities before the index date were hypertension (72%), dyslipidemia (54%), and diabetes (24%); 33% had a history of smoking. During the follow-up period (median, 4.8 years), most patients did not receive treatment with cytoreductive therapy, including phlebotomy (53%), or antiplatelet agents, such as aspirin (57%). The thrombotic and cardiovascular event rates per 1000 patient-years were 60.5 and 83.8, respectively. Among patients who received cytoreductive treatment, the thrombotic event rate was 48.9 per 1000 patient-years. The overall mortality rate was 51.2 per 1000 patient-years. CONCLUSION: The notable rates of thrombotic and cardiovascular events observed in this analysis, even among patients receiving cytoreductive treatment, highlight the important unmet clinical needs of patients with PV in the VHA. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12885-018-4422-6) contains supplementary material, which is available to authorized users.
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spelling pubmed-59359752018-05-11 Cytoreductive treatment patterns among US veterans with polycythemia vera Parasuraman, Shreekant Yu, Jingbo Paranagama, Dilan Shrestha, Sulena Wang, Li Baser, Onur Scherber, Robyn BMC Cancer Research Article BACKGROUND: Polycythemia vera (PV) is a myeloproliferative neoplasm associated with increased thrombotic and cardiovascular risk, which are key contributors to patient morbidity and mortality. The Veterans Health Administration (VHA) is the largest integrative health network in the United States. Available data concerning patients with PV in this population are limited. METHODS: This retrospective observational study evaluated the characteristics, management, and outcomes of patients with PV in the VHA Medical SAS® Dataset (October 1, 2005, to September 30, 2012). Inclusion criteria were ≥ 2 claims for PV (ie, PV diagnostic code was recorded) ≥30 days apart during the identification period, age ≥ 18 years, and continuous health plan enrollment from ≥12 months before the index date until the end of follow-up. All data were analyzed using descriptive statistics. RESULTS: The analysis included 7718 patients (median age, 64 years; male, 98%; white, 64%). The most common comorbidities before the index date were hypertension (72%), dyslipidemia (54%), and diabetes (24%); 33% had a history of smoking. During the follow-up period (median, 4.8 years), most patients did not receive treatment with cytoreductive therapy, including phlebotomy (53%), or antiplatelet agents, such as aspirin (57%). The thrombotic and cardiovascular event rates per 1000 patient-years were 60.5 and 83.8, respectively. Among patients who received cytoreductive treatment, the thrombotic event rate was 48.9 per 1000 patient-years. The overall mortality rate was 51.2 per 1000 patient-years. CONCLUSION: The notable rates of thrombotic and cardiovascular events observed in this analysis, even among patients receiving cytoreductive treatment, highlight the important unmet clinical needs of patients with PV in the VHA. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12885-018-4422-6) contains supplementary material, which is available to authorized users. BioMed Central 2018-05-04 /pmc/articles/PMC5935975/ /pubmed/29728092 http://dx.doi.org/10.1186/s12885-018-4422-6 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Parasuraman, Shreekant
Yu, Jingbo
Paranagama, Dilan
Shrestha, Sulena
Wang, Li
Baser, Onur
Scherber, Robyn
Cytoreductive treatment patterns among US veterans with polycythemia vera
title Cytoreductive treatment patterns among US veterans with polycythemia vera
title_full Cytoreductive treatment patterns among US veterans with polycythemia vera
title_fullStr Cytoreductive treatment patterns among US veterans with polycythemia vera
title_full_unstemmed Cytoreductive treatment patterns among US veterans with polycythemia vera
title_short Cytoreductive treatment patterns among US veterans with polycythemia vera
title_sort cytoreductive treatment patterns among us veterans with polycythemia vera
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5935975/
https://www.ncbi.nlm.nih.gov/pubmed/29728092
http://dx.doi.org/10.1186/s12885-018-4422-6
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