In a nutshell
This study aimed to investigate the impact of a pharmaceutical care program on the safety and effectiveness of ibrutinib in patients with B-cell non-Hodgkin's lymphoma (NHL). This study concluded that the 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 showed 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 the 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 NHL is still under investigation.
Methods & findings
This study involved 155 patients with B-cell cancers including diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma (MCL), and lymphoplasmacytic lymphoma or Waldenstrom macroglobulinemia. All patients received ibrutinib treatment. 27% of patients were assigned to the PC program and 73% were assigned to the usual care group.
The PC 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.
The bottom line
This study concluded that the management of ibrutinib treatment by using a pharmaceutical care program results in improved survival and better tolerance than usual care.
The fine print
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.
Published By :
Annals of Hematology
Jun 01, 2020