Persistence with tamoxifen and aromatase inhibitors in Germany: a retrospective cohort study with 284,383 patients.
Aromatase inhibitors
Breast cancer
Endocrine therapy
Germany
Persistence
Tamoxifen
Journal
Journal of cancer research and clinical oncology
ISSN: 1432-1335
Titre abrégé: J Cancer Res Clin Oncol
Pays: Germany
ID NLM: 7902060
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
received:
06
09
2022
accepted:
20
09
2022
medline:
19
7
2023
pubmed:
24
9
2022
entrez:
23
9
2022
Statut:
ppublish
Résumé
The aim of this study was to analyze the persistence of women on tamoxifen (TAM) and aromatase inhibitors (AIs) in Germany, and to investigate possible determinants of non-persistence. The present retrospective cohort study was based on the IQVIA longitudinal prescription database (LRx). The study included women with an initial prescription of TAM or AIs (anastrozole, letrozole, and exemestane) between January 2016 and December 2020 (index date). Kaplan-Meier analyses were performed to show the persistence for TAM and AI, using a therapy gap of 90 or 180 days, respectively. A multivariable Cox proportional hazards regression model was further used to estimate the relationship between non-persistence and drug prescription (AI versus TAM), age, and the specialty of the physician initiating therapy (gynecologist, oncologist, or general practitioner). Up to 5 years after the index date, only 35.1% of AI and 32.5% of TAM patients were continuing therapy when therapy discontinuation was defined as at least 90 days without therapy. Using a 180-day therapy gap, 51.9% of AI and 50.4% of TAM patients remained on therapy after 5 years. Cox regression models reveal that initial therapy with TAM (HR 1.06, 95% CI 1.04-1.07), therapy initiation by oncologists (HR 1.09, 95% CI 1.07-1.11), or general practitioners (HR 1.24, 95% CI 1.21-1.27) and age ≤ 50 (HR 1.08, 95% CI 1.06-1.10) were significantly associated with an increased risk of therapy discontinuation. Overall, the present study indicates that persistence rates are low in all age groups for both TAM and AI treatment. We found several factors (e.g., physician specialty, younger age, and type of endocrine therapy) to be associated with an increased risk for non-persistence.
Identifiants
pubmed: 36149512
doi: 10.1007/s00432-022-04376-5
pii: 10.1007/s00432-022-04376-5
pmc: PMC10349696
doi:
Substances chimiques
Tamoxifen
094ZI81Y45
Aromatase Inhibitors
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4555-4562Subventions
Organisme : Uniklinikum Giessen und Marburg
ID : 03/2022 MR
Organisme : Stiftung P. E. Kempkes
ID : 01/2021
Informations de copyright
© 2022. The Author(s).
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