Overall Survival and Treatment Patterns Among Patients With Warm Autoimmune Hemolytic Anemia in Sweden: A Nationwide Population-based Study.
autoimmune hemolytic anemia
corticosteroids
immunosuppressants
survival analysis
Journal
European journal of haematology
ISSN: 1600-0609
Titre abrégé: Eur J Haematol
Pays: England
ID NLM: 8703985
Informations de publication
Date de publication:
09 Oct 2024
09 Oct 2024
Historique:
revised:
17
09
2024
received:
27
06
2024
accepted:
18
09
2024
medline:
9
10
2024
pubmed:
9
10
2024
entrez:
9
10
2024
Statut:
aheadofprint
Résumé
Warm autoimmune hemolytic anemia (wAIHA) is a rare autoantibody-mediated disorder, and first-line treatment primarily relies on corticosteroids. This study assessed overall survival (OS) and treatment patterns of wAIHA in Sweden. Adults with ≥ 1 primary diagnosis code for wAIHA (or AIHA plus oral corticosteroids (OCS)/immunosuppressants as sensitivity analyses) between 2011 and 2022 were identified from five Swedish national registers and linked through each patient's unique identity number. Kaplan-Meier curves with log-rank tests and Cox regressions were performed to assess OS for patients with primary versus secondary wAIHA and patients with wAIHA and long-term versus short-term (≥ 3 vs. < 3 months) OCS users. The main analysis included 292 patients; 1791 patients were included in the sensitivity analysis. At a median 3.7-year follow-up, a median OS in primary wAIHA was not reached versus 6.0 years for secondary wAIHA (log-rank test: p = 0.003). Subgroup analyses showed no significant difference in risk of death between long-term and short-term OCS users; however, in the sensitivity analysis, long-term OCS users showed significantly higher risk of death (adjusted hazard ratio: 1.45; 95% confidence interval: 1.180, 1.781; p < 0.001) versus short-term OCS users. Secondary wAIHA or long-term OCS use was associated with lower OS, underscoring the disease burden and unmet need for efficacious wAIHA treatments.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Janssen Global Services, LLC
Informations de copyright
© 2024 The Author(s). European Journal of Haematology published by John Wiley & Sons Ltd.
Références
T. A. Kalfa, “Warm Antibody Autoimmune Hemolytic Anemia,” Hematology: American Society of Hematology. Education Program 2016 (2016): 690–697.
D. L. Hansen, S. Moller, K. Andersen, D. Gaist, and H. Frederiksen, “Increasing Incidence and Prevalence of Acquired Hemolytic Anemias in Denmark, 1980–2016,” Clinical Epidemiology 12 (2020): 497–508.
W. Barcellini, A. Zaninoni, J. A. Giannotta, and B. Fattizzo, “New Insights in Autoimmune Hemolytic Anemia: From Pathogenesis to Therapy Stage 1,” Journal of Clinical Medicine 9 (2020): 3859.
R. A. Brodsky, “Warm Autoimmune Hemolytic Anemia,” New England Journal of Medicine 381 (2019): 647–654.
S. S. Michalak, “Autoimmune Hemolytic Anemia,” in Encyclopedia of Gerontology and Population Aging, eds. D. Gu and M. Dupre (Cham, Switzerland: Springer, 2019), 1–10.
W. Barcellini and B. Fattizzo, “The Changing Landscape of Autoimmune Hemolytic Anemia,” Frontiers in Immunology 11 (2020): 946.
U. Jäger, W. Barcellini, C. M. Broome, et al., “Diagnosis and Treatment of Autoimmune Hemolytic Anemia in Adults: Recommendations From the First International Consensus Meeting,” Blood Reviews 41 (2020): 100648.
S. R. Sudulagunta, M. Kumbhat, M. B. Sodalagunta, et al., “Warm Autoimmune Hemolytic Anemia: Clinical Profile and Management,” Journal of Hematology 6 (2017): 12–20.
E. C. Chen, P. D. Loftus, S. C. Weber, et al., “Autoimmune Hemolytic Anemia Confers an Independent Risk Factor for Thrombosis: Retrospective Cohort Study Using the “STRIDE” Database,” Annals of Hematology & Oncology 4 (2017): 1160.
S. Audia, B. Bach, M. Samson, et al., “Venous Thromboembolic Events During Warm Autoimmune Hemolytic Anemia,” PLoS One 13 (2018): e0207218.
B. Fattizzo, M. Bortolotti, J. A. Giannotta, A. Zaninoni, D. Consonni, and W. Barcellini, “Intravascular Hemolysis and Multitreatment Predict Thrombosis in Patients With Autoimmune Hemolytic Anemia,” Journal of Thrombosis and Haemostasis 20 (2022): 1852–1858.
D. J. Kuter, “Warm Autoimmune Hemolytic Anemia and the Best Treatment Strategies,” Hematology: American Society of Hematology. Education Program 2022 (2022): 105–113.
F. Cavallaro, W. Barcellini, and B. Fattizzo, “Antibody Based Therapeutics for Autoimmune Hemolytic Anemia,” Expert Opinion on Biological Therapy 23 (2023): 1227–1237.
S. Berentsen and W. Barcellini, “Autoimmune Hemolytic Anemias,” New England Journal of Medicine 385 (2021): 1407–1419.
M. Michel, L. Terriou, F. Roudot‐Thoraval, et al., “A Randomized and Double‐Blind Controlled Trial Evaluating the Safety and Efficacy of Rituximab for Warm Auto‐Immune Hemolytic Anemia in Adults (the RAIHA Study),” American Journal of Hematology 92 (2017): 23–27.
J. Maquet, M. Lafaurie, O. Walter, et al., “Epidemiology of Autoimmune Hemolytic Anemia: A Nationwide Population‐Based Study in France,” American Journal of Hematology 96 (2021): E291–E293.
D. L. Hansen, S. Moller, and H. Frederiksen, “Survival in Autoimmune Hemolytic Anemia Remains Poor, Results From a Nationwide Cohort With 37 Years of Follow‐Up,” European Journal of Haematology 109 (2022): 10–20.
E. Rattarittamrong, P. Eiamprapai, A. Tantiworawit, et al., “Clinical Characteristics and Long‐Term Outcomes of Warm‐Type Autoimmune Hemolytic Anemia,” Hematology 21 (2016): 368–374.
J. C. Zhou, M. Q. Wu, Z. M. Peng, W. H. Zhao, and Z. J. Bai, “Clinical Analysis of 20 Patients With Non‐Hodgkin Lymphoma and Autoimmune Hemolytic Anemia: A Retrospective Study,” Medicine (Baltimore) 99 (2020): e19015.
ICD10Data.com, “Warm Autoimmune Hemolytic Anemia,” 2023, https://www.icd10data.com/ICD10CM/Codes/D50‐D89/D55‐D59/D59‐/D59.11#:~:text=Warm%20autoimmune%20hemolytic%20anemia,‐2021%20%2D%20New%20Code&text=Billable%2FSpecific%20Code‐,D59.,effective%20on%20October%201%2C%202022.
J. F. Ludvigsson, E. Andersson, A. Ekbom, et al., “External Review and Validation of the Swedish National Inpatient Register,” BMC Public Health 11 (2011): 450.
G. Broms, J. Soderling, M. C. Sachs, et al., “Capturing Biologic Treatment for IBD in the Swedish Prescribed Drug Register and the Swedish National Patient Register—A Validation Study,” Scandinavian Journal of Gastroenterology 56 (2021): 410–421.
H. L. Brooke, M. Talbäck, J. Hörnblad, et al., “The Swedish Cause of Death Register,” European Journal of Epidemiology 32 (2017): 765–773.
E. Pukkala, G. Engholm, L. K. Højsgaard Schmidt, et al., “Nordic Cancer Registries—An Overview of Their Procedures and Data Comparability,” Acta Oncologica 57 (2018): 440–455.
J. F. Ludvigsson, P. Svedberg, O. Olén, G. Bruze, and M. Neovius, “The Longitudinal Integrated Database for Health Insurance and Labour Market Studies (LISA) and Its Use in Medical Research,” European Journal of Epidemiology 34 (2019): 423–437.
B. Wettermark, H. Zoega, K. Furu, et al., “The Nordic Prescription Databases as a Resource for Pharmacoepidemiological Research—A Literature Review,” Pharmacoepidemiology and Drug Safety 22 (2013): 691–699.
J. F. Ludvigsson, C. Almqvist, A. K. Bonamy, et al., “Registers of the Swedish Total Population and Their Use in Medical Research,” European Journal of Epidemiology 31 (2016): 125–136.
J. Blackwell, C. Selinger, T. Raine, G. Parkes, M. A. Smith, and R. Pollok, “Steroid Use and Misuse: A Key Performance Indicator in the Management of IBD,” Frontline Gastroenterology 12 (2021): 207–213.
M. Nogué, J. Rambaud, S. Fabre, N. Filippi, C. Jorgensen, and Y. M. Pers, “Long‐Term Corticosteroid Use and Dietary Advice: A Qualitative Analysis of the Difficulties Encountered by Patient,” BMC Health Services Research 19 (2019): 255.
T. N. Tran, S. MacLachlan, W. Hicks, et al., “Oral Corticosteroid Treatment Patterns of Patients in the United States With Persistent Asthma,” Journal of Allergy and Clinical Immunology: In Practice 9 (2021): 338–346.
J. F. Ludvigsson, P. Appelros, J. Askling, et al., “Adaptation of the Charlson Comorbidity Index for Register‐Based Research in Sweden,” Clinical Epidemiology 13 (2021): 21–41.
A. K. Waljee, M. A. Rogers, P. Lin, et al., “Short Term Use of Oral Corticosteroids and Related Harms Among Adults in the United States: Population Based Cohort Study,” BMJ 357 (2017): j1415.
B. Bannwarth, “Drug‐induced musculoskeletal disorders,” Drug Safety 30 (2007): 27–46.
F. Petrelli, D. Signorelli, M. Ghidini, et al., “Association of Steroids Use With Survival in Patients Treated With Immune Checkpoint Inhibitors: A Systematic Review and Meta‐Analysis,” Cancers (Basel) 12 (2020): 546.