Clinical role of filgrastim in the management of patients at risk of prolonged severe neutropenia: An evidence‐based review

Bongiovanni, Alberto; Recine, Federica; Fausti, Valentina; Rossi, Benedetta; Mercatali, Laura; Liverani, Chiara; Vita, Alessandro De; Gurrieri, Lorena; Bonis, Silvia De; Miserocchi, Giacomo; Spadazzi, Chiara; Calpona, Sebastiano; Riva, Nada; Cocchi, Claudia; Ibrahim, Toni

doi:10.1111/ijcp.13404

Cited by 5 publications

(4 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The two G-CSFs compared in the present analysis were manufactured by Chinese pharmaceutical companies, and some clinical evidence demonstrated differences in effectiveness and safety ( Liverani et al, 2014 ; Zhang et al, 2018a ; Huang et al, 2018 ; Bongiovanni et al, 2019 ; Zhu et al, 2019 ; Ma et al, 2020 ; Huang et al, 2021 ). The PEG-rhG-CSF is recommended as a higher compliance treatment by current guidelines ( Chinese Society of Clinical Oncology Guidance Working Committee, 2017 ).…”

Section: Discussionmentioning

confidence: 96%

Cost-Effectiveness Analysis of PEG-rhG-CSF as Primary Prophylaxis to Chemotherapy-Induced Neutropenia in Women With Breast Cancer in China: Results Based on Real-World Data

et al. 2022

View full text Add to dashboard Cite

Background: Pegylated recombinant human granulocyte colony-stimulating factors (PEG-rhG-CSFs) are more commonly and widely used than recombinant human granulocyte colony-stimulating factors (rhG-CSFs) in preventing chemotherapy-induced neutropenia in patients with stage II-IV breast cancer. To reduce the financial burden on these patients, the corresponding medical insurance directory needs to be revised.Objectives: To evaluate the cost-effectiveness of PEG-rhG-CSF versus rhG-CSF in patients with stage II-IV breast cancer in central China.Methods: Two Markov models, a chemotherapy model and a post-chemotherapy model, were developed to study the effects and costs, with a time horizon of 12 weeks and 35 years, respectively. Cost and probability input data were primarily obtained from a retrospective real-world study conducted in five tertiary hospitals. Propensity score matching was adopted to overcome retrospective bias. Other parameters were extracted from literature as well as advice from clinical experts. Univariate and probabilistic sensitivity analyses were conducted.Results: In the first chemotherapy model, PEG-rhG-CSF was associated with fewer episodes of febrile neutropenia (FN) (N = 19 per 1000 patients treated), infections (N = 24 per 1000 patients treated) and deaths (N = 2 per 1000 patients treated), but higher costs (¥36 more per patient treated). The post-chemotherapy model indicated that PEG-rhG-CSF led to higher gains in quality-adjusted life years (QALYs) (11.695 versus 11.516) in comparison to rhG-CSF. Sensitivity analysis showed that the cost of PEG-rhG-CSF had the greatest impact on the incremental costs, and incremental QALYs were very sensitive to the risk of RDI <85%. The probability of PEG-rhG-CSF being cost-effective compared to rhG-CSF was 66% at the willingness to pay (WTP) thresholds of ¥72,371 per QALY gained.Conclusion: According to this economic evaluation based on real-world data, PEG-rhG-CSF may be considered as a more cost-effective strategy relative to rhG-CSF for stage II-IV breast cancer patients in central China. However, to reflect a national perspective, further evidence is needed using data from larger-scale studies.

show abstract

Section: Discussionmentioning

confidence: 96%

Cost-Effectiveness Analysis of PEG-rhG-CSF as Primary Prophylaxis to Chemotherapy-Induced Neutropenia in Women With Breast Cancer in China: Results Based on Real-World Data

et al. 2022

View full text Add to dashboard Cite

show abstract

“…17 Bongiovanni et al describieron que el uso de Filgrastim en pacientes con leucemia linfoblástica aguda después de una QT intensiva, reducía significativamente la duración de la neutropenia y los tiempos de hospitalización respecto al grupo control (mediana de 16 vs 32 días [p <0.001] y 22 vs 28 días [p= 0.02]. 18 Adicionalmente, los pacientes con linfoma no Hodgkin mostraron una menor tasa de NF con dosis plena de QT, encontrando mejores resultados. 18 En el metaanálisis realizado por Lyman et al que evalúo la mortalidad general atribuible a la profilaxis con G-CSF, con un periodo de seguimiento de dos años, se encontró que el riesgo de muerte con el uso de profilaxis de G-CSF era significativamente menor, reportando un RR= 0.90 (IC 95 % 0.86-0.94).…”

Section: Discussionunclassified

“…18 Adicionalmente, los pacientes con linfoma no Hodgkin mostraron una menor tasa de NF con dosis plena de QT, encontrando mejores resultados. 18 En el metaanálisis realizado por Lyman et al que evalúo la mortalidad general atribuible a la profilaxis con G-CSF, con un periodo de seguimiento de dos años, se encontró que el riesgo de muerte con el uso de profilaxis de G-CSF era significativamente menor, reportando un RR= 0.90 (IC 95 % 0.86-0.94).…”

Section: Discussionunclassified

Estudio FIRES: Filgrastim - investigación retrospectiva de efectividad y seguridad en una institución de salud en Colombia

Fontalvo¹,

Esteban²,

Esteban³

et al. 2023

Rev.Col.Hematol.Oncol

View full text Add to dashboard Cite

La quimioterapia (QT) como forma de tratamiento de las neoplasias provoca neutropenia, neutropenia febril y mielosupresión, lo que favorece la presentación de infecciones, sepsis, muerte y una menor respuesta inmunitaria. Los factores estimulantes de colonias son una alternativa terapéutica que mejora la supervivencia y la respuesta inmunitaria de los pacientes con neoplasias. Métodos: se llevó a cabo un estudio observacional retrospectivo analítico en pacientes con neoplasias atendidos en una institución de salud especializada entre los años 2017 y 2019 en la ciudad de Bogotá y tratados con Filgrastim, que presentaron neutropenia febril, abordando la respuesta clínica y seguridad en términos de aumento de neutrófilos. Resultados: la muestra estuvo comprendida por 133 pacientes, se encontró que los pacientes tuvieron mayor cantidad de complicaciones por linfoma no Hodgkin con un 44.4 % (n=59), seguido por leucemia 36.1 % (n=48) y otros tumores 12 % (n=16), de los cuales el 29 % (n=38) se clasificó en el estadio 4, el 12 % (n=16) en estadio 3 y el 9 % (n=12) en estadio 2 de su patología neoplásica. El grupo de pacientes tratados con Filgrastim presentó un aumento en el recuento de neutrófilos posterior al inicio de tratamiento (p= 0.04). Conclusiones: la neutropenia febril se presenta en cualquier edad, siendo más frecuente en la sexta década de vida. El Filgrastim demostró ser un medicamento efectivo y seguro, como parte de la intervención terapéutica en pacientes con diagnóstico oncológico bajo esquemas de QT, representando mejoría del recuento de neutrófilos.

show abstract

“…Moreover, others include leukocytosis, back pain, anemia and secondary malignancies risk, but no fatal complication was noted [14][15][16] . In fact, all of these adverse events appear to be related, and the toxicities are associated with PEG-rhG-CSF efficacy and with an increased neutrophil count [17] . In the study, we found a common hypoglycemic complication secondary to PEG-rhG-CSF use.…”

Section: Discussionmentioning

confidence: 99%

PEG-rhG-CSF Use Reduces Glucose Level Significantly in Cancer Patients Receiving Chemotherapy

Cui¹,

Liu²,

Zhang³

et al. 2020

PAR

View full text Add to dashboard Cite

Background: In patients receiving anti-cancer chemotherapy, polyethylene glycolated recombinant human granulocyte-colony stimulating factor (PEG-rhG-CSF) was used for prophylaxis of chemotherapy-induced neutropenia. However, the side effect of PEG-rhG-CSF use on fasting blood glucose (FBG) level remains unclear. Materials and Methods: Cancer patients receiving chemotherapy and PEG-rhG-CSF were enrolled in our study. Baseline glucose (Glucose 1) was measured before PEG-rhG-CSF use, a second FBG test (Glucose 2) was performed after PEG-rhG-CSF use. Mean glucose levels were compared using t test. Results: The time interval between PEG-rhG-CSF use and the second glucose test was 2.4±1.5 days. The mean Glucose 1 was 5.18±0.53 mmol/L, and Glucose 2 was 3.80±1.13 mmol/L. Statistical analysis showed a significant difference between Glucose 1 and 2 existed (P<0.001). Conclusion: Our study identifies a hypoglycemic side effect of PEG-rhG-CSF occurs in cancer patients undergoing anti-cancer chemotherapy. Our results highlight the caution required when using PEG-rhG-CSF for prophylaxis of chemotherapy-induced neutropenia.

show abstract

Clinical role of filgrastim in the management of patients at risk of prolonged severe neutropenia: An evidence‐based review

Cited by 5 publications

References 54 publications

Cost-Effectiveness Analysis of PEG-rhG-CSF as Primary Prophylaxis to Chemotherapy-Induced Neutropenia in Women With Breast Cancer in China: Results Based on Real-World Data

Cost-Effectiveness Analysis of PEG-rhG-CSF as Primary Prophylaxis to Chemotherapy-Induced Neutropenia in Women With Breast Cancer in China: Results Based on Real-World Data

Estudio FIRES: Filgrastim - investigación retrospectiva de efectividad y seguridad en una institución de salud en Colombia

PEG-rhG-CSF Use Reduces Glucose Level Significantly in Cancer Patients Receiving Chemotherapy

Contact Info

Product

Resources

About