Evidence map›Paper›PMID 41423437›Full record

ArticleCancer medicine2025

Healthcare Resource Utilization and Costs in Patients With Chronic Lymphocytic Leukemia or Small Lymphocytic Leukemia Treated With Covalent Bruton's Tyrosine Kinase Inhibitors: Real-World Impact of Cardiovascular Adverse Events.

Mavis Obeng-Kusi, Enrico De Nigris, Siyang Leng, Mohammed Z H Farooqui, Halit O Yapici, Ian Weimer, Weiqi Jiao, Hayden W Hyatt, Xuan Zhang, Kunal Lodaya and 1 more

Abstract read
In one paragraph

Article in Cancer medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Mavis Obeng-KusiMerck & Co., Inc., Rahway, New Jersey, USA.
Enrico De NigrisMSD (UK) Limited, London, UK.
Siyang LengMerck & Co., Inc., Rahway, New Jersey, USA.
Mohammed Z H FarooquiMerck & Co., Inc., Rahway, New Jersey, USA.
Halit O YapiciBoston Strategic Partners, Inc., Boston, Massachusetts, USA.
Ian WeimerBoston Strategic Partners, Inc., Boston, Massachusetts, USA.
Weiqi JiaoBoston Strategic Partners, Inc., Boston, Massachusetts, USA.
Hayden W HyattBoston Strategic Partners, Inc., Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0001-8075-5670
Xuan ZhangBoston Strategic Partners, Inc., Boston, Massachusetts, USA.
Kunal LodayaBoston Strategic Partners, Inc., Boston, Massachusetts, USA.
David DingliMayo Clinic, Rochester, Minnesota, USA.

Funding

Merck Sharp and Dohme
6 · The paper itself

Abstract

introductionAlthough covalent Bruton's tyrosine kinase inhibitors (cBTKis) have transformed treatment of chronic lymphocytic leukemia and small lymphocytic leukemia (CLL/SLL), cBTKi-related cardiotoxicity is a known side effect. This real-world study evaluated incident cardiovascular adverse events (CVAE), healthcare resource utilization (HCRU), and costs among patients with CLL/SLL receiving cBTKis.

methodsAdult patients with CLL/SLL who initiated ibrutinib or acalabrutinib treatment (index date) between 2020 and 2023 were identified using US claims data and followed up to 36 months post-index. Incident CVAEs (not present pre-index) were assessed during cBTKi treatment and patients were stratified by CVAE status. HCRU and costs were evaluated per 1000 patient-months (PPPM).

resultsOverall, 2069 patients were identified (mean age of 73.7 ± 9.1 years, 40.4% female) with a mean treatment-specific observation period of 11.4 ± 9.5 months. At least one incident CVAE was observed in 442 (21.4%) patients. The incidence rate was 21.6 PPPM for hypertension, 8.9 PPPM for atrial fibrillation, 8.6 PPPM for ventricular arrhythmias, and 8.3 PPPM for atrial flutter. Patients with incident CVAEs had significantly more total medical service days PPPM (4334 vs. 3138, p < 0.001), primarily driven by increased inpatient (690 vs. 230), outpatient (2798 vs. 2425), other visit (662 vs. 375), and ER days (184 vs. 109) than those without CVAEs. Total healthcare costs (PPPM) were substantially higher for patients with incident CVAEs ($20,250,560 vs. $17,413,460, p < 0.001) mainly due to higher inpatient ($3,417,948 vs. $915,839, p < 0.001), outpatient ($2,415,060 vs. $1,769,628, p < 0.01), and ER costs ($186,820 vs. $87,585, p < 0.001).

conclusionsThe observed class-effect of high CVAEs with cBTKis underscores the unmet need for safer, more selective agents for CLL/SLL treatment. The HCRU and economic burden remain high for CLL/SLL, especially among patients experiencing CVAEs during cBTKi treatment. These findings emphasize the importance of optimizing clinical management to reduce CVAE risk and downstream impacts on HCRU and costs.

Indexed as

Agammaglobulinaemia Tyrosine KinaseCardiovascular DiseasesHealth Care CostsLeukemia, Lymphocytic, Chronic, B-CellPatient Acceptance of Health CareProtein Kinase InhibitorsAdenineAgedAged, 80 and overBenzamidesCardiotoxicityFemaleHealth ResourcesHumansIncidenceMaleacalabrutinibAdenineAgammaglobulinaemia Tyrosine KinaseBenzamidesBTK protein, humanibrutinibPiperidinesProtein Kinase InhibitorsPyrazinesTyrosine Kinase Inhibitorsepidemiologyleukemiatarget therapytyrosine kinase inhibitors

Identifiers

PMID41423437
PMCPMC12719235

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.