The impact of a pharmaceutical care program for patients with chronic lymphocytic leukemia treated with ibrutinib

This study aimed to investigate the impact of a pharmaceutical care program on the safety and effectiveness of ibrutinib in patients with chronic lymphocytic leukemia.

This study concluded that management of ibrutinib treatment by using a pharmaceutical care program results in improved survival and better tolerance than usual care. 

Ibrutinib (Imbruvica) treatment has been shown to increase survival in patients with B-cell cancers. B-cell cancers include some types of non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL).  

Real-life data on ibrutinib treatment shows that patients commonly end treatment due to side effects. This interferes with the effectiveness of ibrutinib. Pharmaceutical care (PC) is patient-centered and aims to achieve the best outcomes for a patient. A PC program includes patient education for management of side effects, adherence monitoring, interventions to reduce drug-drug interactions, and a follow-up of transition from hospital to the community. 

The impact of a PC program on the safety and effectiveness of ibrutinib in patients with CLL is still under investigation.

This study involved 155 patients with B-cell cancers including CLL. All patients received ibrutinib treatment. 27% of patients were assigned to the PC program and 73% were assigned to the usual care group.   

The program group experienced increased time to treatment failure when compared to the usual care group. At 30 months, the PC group had not experienced treatment failure compared to an average time to treatment failure of 27 months in the usual care group.  

At 6 months, 90% of the PC group were still receiving treatment, compared to 60% in the usual care group. The average survival without cancer worsening exceeded 30 months in the PC group compared to 14 months in the usual care group. 

15% of patients in the usual care group experienced serious side effects compared to 8% of the PC group. No patient in the PC group stopped treatment due to side effects compared to 25% of the usual care group.

This study concluded that management of ibrutinib treatment by using a pharmaceutical care program results in improved survival and better tolerance than usual care. 

This study had a small number of participants. Also, patients were not randomly assigned to the groups, but their doctor decided who should receive the PC program. This might have affected the results. Further randomized trials are needed.