Researchers from Belgium have reported that the compliance rate for Gleevec® (imatinib) in patients with newly diagnosed chronic myeloid leukemia (CML) is much less than expected. The details of this study appeared in an early online publication in Blood on April 6, 2009.[1]
The development of the tyrosine kinase inhibitor Gleevec has revolutionized the treatment of patients with CML. However, it is important for patients to take Gleevec on a daily basis; 600 mg per day has been found to be more effective than 400 mg per day. In most of the reported clinical trials, the fraction of patients defined as intolerant or non-compliant is very low.
Researchers involved in the current study, ADAGIO (Adherence Assessment with Gleevec®: Indicators and Outcome), was a prospective study to determine Gleevec compliance in 169 patients with CML treated in 34 medical centers in Belgium over a 90-day period. The mean age of this group was 57 years. These authors defined the conditions as “a real practice setting” rather than a clinical trial setting. The average time from diagnosis was approximately four years.
They found that only 14% of patients in this study were 100% compliant in taking Gleevec and one-third were deemed non-adherent to the prescribed dose schedule. Interestingly, 14% of patients took more Gleevec than prescribed. Patients with suboptimal responses were less likely to be compliant with taking Gleevec than were good responders. Poor compliance was not related to length of treatment or to side effects of Gleevec. Poor compliance occurred despite the fact that patients knew they would be monitored for compliance, as they had signed a consent form for this purpose. There was some suggestion in this study that poor compliance was greater in older individuals, in males, and in persons living alone.
These authors suggest that compliance to Gleevec has to be monitored and assessed routinely.
Comments: These are important observations that are similar to other observations when oral drugs are prescribed for long periods of time, such as anti-estrogens in women with early-stage breast cancer. One important message from this study is that non-compliance can lead to suboptimal responses and could be corrected by improving compliance.
Reference:
[1] Noens L, van Lierde M-A, De Bock R, et al. Prevalence, determinants, and outcomes of nonadherence to imatinib therapy in patients with chronic myeloid leukemia: the ADAGIO study. Blood [early on-line publication]. April 6, 2009.
© 1998-2007 OncoEd.com All Rights Reserved.
These materials may discuss uses and dosages for therapeutic products that have not been approved by the United States Food and Drug Administration. All readers should verify all information and data before administering any drug, therapy or treatment discussed herein. Neither the editors nor the publisher accepts any responsibility for the accuracy of the information or consequences from the use or misuse of the information contained herein.
Patient Home
