Drug Utilisation of Radium-223 Under Routine Clinical Practice (DIRECT) in Europe: A Post-Authorisation Safety Study.

IF 3.2 Q2 ONCOLOGY
Rachel Weinrib, Joan Fortuny, David Martinez, Bianca Kollhorst, Ulrike Haug, Astrid Kousholt, Vera Ehrenstein, Peter Iversen, Jann Mortensen, Dianne Bosch, Malou Kuppen, Federica Pisa, Zdravko Vassilev
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引用次数: 0

Abstract

Introduction: Radium-223 is indicated for adults with metastatic castration-resistant prostate cancer (mCRPC) and symptomatic bone metastases, without visceral metastases, who progress after at least (≥) two lines of or are ineligible for other systemic therapies (besides luteinising hormone-releasing hormone analogues). Radium-223 is contraindicated in combination with abiraterone acetate and prednisone/prednisolone. Point 2 and the contraindication above were added to the 2018 European Medicines Agency (EMA) label. In the observational cohort study reported here, we evaluated compliance with the 2018 revised label.

Methods: The proportion of patients with mCRPC who initiated radium-223 in the Netherlands, Germany and Denmark was analysed descriptively before (2013-2017) and after (2019-2020) the label change, allowing ≥ 6 months of follow-up. No a priori hypotheses were evaluated.

Results: A total of 1070 patients were included in this observational cohort study (before/after the label change: Netherlands [243/53]; Germany [580/71]; Denmark [60/63]). Radium-223 use with abiraterone acetate or other systemic mCRPC therapies was limited and decreased after the label change in the Netherlands and Germany; in Denmark, combined use was not observed before the label change and was observed only rarely after the label change. After the label change, radium-223 use without ≥ 2 prior lines of systemic mCRPC therapy decreased in all countries, despite remaining relatively common in the Netherlands and Germany.

Conclusions: Radium-223 use in combination with abiraterone acetate or other systemic mCRPC therapies largely aligned with the 2018 EMA label change. However, after the label change, radium-223 use without ≥ 2 prior lines of systemic mCRPC therapy remained relatively common in the Netherlands and Germany, possibly because radium-223 was previously recommended as first-line treatment for frail patients, and doctors still may consider it for use in these cases. We could not assess patients' eligibility for other systemic mCRPC therapies; therefore, these findings may partly reflect radium-223 on-label use in patients with contraindications for other systemic therapies.

Ema study identification number: EUPAS37163.

欧洲常规临床实践(DIRECT)下镭-223的药物利用:一项批准后的安全性研究
镭-223适用于转移性去势抵抗性前列腺癌(mCRPC)和症状性骨转移,无内脏转移,在至少(≥)两条线治疗后进展或不适合其他全身治疗(除了促黄体激素释放激素类似物)的成人。镭-223禁忌与醋酸阿比特龙和强的松/强的松合用。第2点和上述禁忌症已添加到2018年欧洲药品管理局(EMA)的标签中。在本文报道的观察性队列研究中,我们评估了2018年修订标签的依从性。方法:描述性分析荷兰、德国和丹麦在标签改变之前(2013-2017)和之后(2019-2020)开始使用镭-223治疗的mCRPC患者比例,允许随访≥6个月。没有先验假设被评估。结果:该观察性队列研究共纳入1070例患者(标签更改前/后:荷兰[243/53];德国(580/71);丹麦[60/63])。在荷兰和德国,在标签变更后,镭-223与醋酸阿比特龙或其他系统性mCRPC治疗的使用受到限制并减少;在丹麦,在标签改变之前没有观察到联合使用,而在标签改变之后很少观察到联合使用。标签变更后,在所有国家中,在未接受过≥2条系统性mCRPC治疗的情况下,镭-223的使用都有所减少,尽管在荷兰和德国仍然相对普遍。结论:镭-223联合醋酸阿比特龙或其他系统性mCRPC疗法的使用基本符合2018年EMA标签的变化。然而,在标签改变后,在荷兰和德国,在没有接受过2条以上系统性mCRPC治疗的情况下使用镭-223仍然相对普遍,这可能是因为镭-223以前被推荐为体弱患者的一线治疗,医生仍然可能考虑在这些病例中使用镭-223。我们无法评估患者接受其他系统性mCRPC治疗的资格;因此,这些发现可能部分反映了镭-223在有其他全身治疗禁忌症的患者中的标签使用。Ema研究识别号:EUPAS37163。
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来源期刊
CiteScore
3.40
自引率
0.00%
发文量
31
审稿时长
6 weeks
期刊介绍: Now indexed in PubMed Aims and Scope Oncology and Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality pre-clinical, clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Oncology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research. Rapid Publication The journal’s rapid publication timelines aim for a peer review decision within 2 weeks of submission. If an article is accepted it will be published online 3-4 weeks from acceptance. These rapid timelines are achieved through the combination of a dedicated in-house editorial team, who closely manage article workflow, and an extensive Editorial and Advisory Board who assist with rapid peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid and efficient communication of the latest research and reviews, allowing the advancement of clinical therapies. Personal Service The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning that authors will always have a personal point of contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE, GPP and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. We also encourage pre-submission enquiries and are always happy to provide a confidential assessment of manuscripts. Digital features and plain language summaries Oncology and Therapy offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by key summary points, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand the scientific content and overall implications of the article. The journal also provides the option to include various types of digital features including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations. All additional features are peer reviewed to the same high standard as the article itself. If you consider that your paper would benefit from the inclusion of a digital feature, please let us know. Our editorial team are able to create high-quality slide decks and infographics in-house, and video abstracts through our partner Research Square, and would be happy to assist in any way we can. For further information about digital features, please contact the journal editor (see ‘Contact the Journal’ for email address), and see the ‘Guidelines for digital features and plain language summaries’ document under ‘Submission guidelines’. Preprints We encourage posting of preprints of primary research manuscripts on preprint servers, authors'' or institutional websites, and open communications between researchers whether on community preprint servers or preprint commenting platforms. Posting of preprints is not considered prior publication and will not jeopardize consideration in our journals. Please see here for further information on preprint sharing: https://www.springer.com/gp/authors-editors/journal-author/journal-author-helpdesk/submission/1302#c16721550 Peer Review Process Upon submission, manuscripts are assessed by the editorial team to ensure they fit within the aims and scope of the journal and are also checked for plagiarism. All suitable submissions are then subject to a comprehensive single-blind peer review. Reviewers are selected based on their relevant expertise and publication history in the subject area. The journal has an extensive pool of editorial and advisory board members who have been selected to assist with peer review based on the afore-mentioned criteria. At least two extensive reviews are required to make the editorial decision, with the exception of some article types such as Commentaries, Editorials and Letters which are generally reviewed by one member of the Editorial Board. Where reviewer recommendations are conflicted, the editorial board will be contacted for further advice and a presiding decision. Manuscripts are then either accepted, rejected or authors are required to make major or minor revisions (both reviewer comments and editorial comments may need to be addressed). Once a revised manuscript is re-submitted, it is assessed along with the responses to reviewer comments and if it has been adequately revised it will be accepted for publication. Accepted manuscripts are then copyedited and typeset by the production team before online publication. Appeals against decisions following peer review are considered on a case by case basis and should be sent to the journal editor. Copyright Oncology and Therapy''s content is published open access under the Creative Commons Attribution-Noncommercial License, which allows users to read, copy, distribute, and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited. The author assigns the exclusive right to any commercial use of the article to Springer. For more information about the Creative Commons Attribution-Noncommercial License, click here: http://creativecommons.org/licenses/by-nc/4.0 Publication Fees Upon acceptance of an article, authors will be required to pay the mandatory Rapid Service Fee of £3650/€4500/$5100. The journal will consider fee discounts for developing countries and this is decided on a case by case basis. Open Access All articles published by Oncology and Therapy are published open access Contact For more information about the journal, including pre-submission enquiries, please contact managing editor Lydia Alborn at lydia.alborn@springer.com.
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