Poly(ADP-ribose) polymerase inhibitors: toxicity and costs
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PharmacoEconomics & Outcomes News 861, p30 - 5 Sep 2020 Poly(ADP-ribose) polymerase inhibitors: toxicity and costs Real-world use of poly(ADP-ribose) polymerase (PARP) inhibitors in patients with gynaecological cancers requires more dosage modifications and discontinuations for the management of adverse events (AEs) than previously reported in clinical trials and is costly, according to findings of a US study published in Gynecologic Oncology. The toxicity profile and financial burden of PARP inhibitors were investigated by conducting a retrospective chart review of patients with recurrent ovarian, primary peritoneal or fallopian tube cancer who initiated olaparib, niraparib or rucaparib at a community oncology practice in Phoenix, Arizona, between December 2016 and November 2018. In total, 47 patients received 506 28-day cycles of niraparib (58% of cycles), olaparib (24%) or rucaparib (18%). Patients were covered by federal insurance (17.7%), private insurance (46.7%) or both (35.6%). Overall, the most frequently reported all-grade AEs were nausea (63% of patients) and fatigue (45%), and the most frequently reported grade ≥3 AE was anaemia (31%). Thrombocytopenia was reported in 11 patients. Grade ≥3 toxicity was reported in 17%, 27% and 43% of patients receiving olaparib, rucaparib and niraparib, respectively, and led to dose interruption in 69% of cycles, dosage reduction in 63% and treatment discontinuation in 29%. Niraparib was associated with more frequent dose interruptions but fewer treatment discontinuations than olaparib or rucaparib (p
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