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6ER-037 Pharmaco-utilisation of ibrutinib in CLL: a single centre study
  1. G Faitelli,
  2. A Ucciero,
  3. A Pisterna
  1. Hospital Pharmacy- Aou Maggiore Della Carità- Novara, Hospital Pharmacy, Novara, Italy


Background and Importance Chronic lymphocytic leukaemia (CLL) is a B-cell neoplasm characterised by the clonal expansion of mature B lymphocytes. Ibrutinib, an irreversible inhibitor of Bruton tyrosine kinase, is prescribed for CLL treatment at all stages. Being an oral treatment, strict adherence is closely linked to clinical outcomes.

Aim and Objectives The study aims to measure ibrutinib adherence and persistence in real-world CLL patients, and analyse their correlation with patient demographics, clinical factors, and genetics in a Northern Italian University Hospital.

Material and Methods This retrospective study included CLL patients aged 18 or older who received ibrutinib monotherapy for at least 6 months (observed between 2016 and 30/06/2023). Prescription data came from electronic prescribing software, and clinical information was sourced from AIFA Registries. Adherence was assessed using the ratio of received to prescribed daily doses (RDD/PDD), and persistence was determined by the average duration of therapy before discontinuation (in days). Patients with a RDD/PDD ratio ≥ 0.9 were considered adherent.

Results Among the 42 subjects in this study, the average ibrutinib adherence rate was 0.75 (ranging from 0.45 to 1).There were no notable differences in adherence rates based on demographic or clinical characteristics. Interestingly, a majority of patients (57%) with unfavourable cytogenetics had an RDD/PDD ratio below 0.9. Among patients who experienced adverse reactions, 86% belonged to the low adherence group, while seven subjects with disease progression were evenly split between the two adherence groups. Out of the20 patients who discontinued treatment, only one had a favourable cytogenetic profile (IGHV-mutated; noTP53 mutation or del(17p)). The average time to discontinuation was shorter for subjects who experienced toxicity (976 days) compared to those who had disease progression (1312 days).

Conclusion and Relevance In patients with CLL treated with ibrutinib, mean adherence was lower than rates seen in clinical trials. Apparently, demographic and clinical characteristics did not influence treatment adherence. However, a lower adherence rate was observed in higher-risk groups, and nearly all patients who discontinued treatment exhibited an unfavourable cytogenetic profile. It’s worth noting that the connection between high-risk cytogenetics and poor adherence has not been explored in literature, highlighting the need to investigate this relationship in a larger patient sample.

Conflict of Interest No conflict of interest.

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