Real-World Treatment Patterns and Healthcare Resource Utilization of Bruton Tyrosine Kinase Inhibitors for the Treatment of Mantle Cell Lymphoma in the United States.

The introduction of Bruton tyrosine kinase inhibitors (BTKis) to the mantle cell lymphoma (MCL) treatment paradigm has shown promising results for patient outcomes. However, insufficient real-world evidence remains to compare the outcomes of different BTKi treatments in MCL. This study aimed to analyze BTKi utilization and differences in patient characteristics, treatment outcomes, and healthcare resource utilization among patients with MCL during their first use of BTKi therapy. A retrospective study was conducted using Symphony Integrated Dataverse (IDV), which is a longitudinal, de-identified U.S. healthcare claims database. The study included patients with MCL with their first BTKi administered as monotherapy or in combination with other agents between 1/1/2020 and 12/31/2022. Patients were followed at least 90 days after BTKi initiation until the end of the study period or until lost to follow-up (3/31/2023). Patient demographics and clinical characteristics were measured at baseline. Time to discontinuation, treatment duration, switching, compliance, and healthcare resource utilization (per patient per month [PPPM]) were measured during the follow-up period. A total of 1458 patients initiating their first BTKi were included in the study: 667 in the acalabrutinib group, 509 in the ibrutinib group, and 282 in the zanubrutinib group. Switching rates within 90 days were lowest for the zanubrutinib group (0.71%), followed by the acalabrutinib group (1.8%) and then the ibrutinib group (2.16%). The median time to discontinuation was longest for the zanubrutinib group (188.5 days) compared to the acalabrutinib group (179 days) and the ibrutinib group (161.5 days). Compliance at 360 days was significantly different across the BTKis, highest for the zanubrutinib group (16.9%), followed by the acalabrutinib group (13.2%) and the ibrutinib group (10.8%). The zanubrutinib group had numerically lower mean PPPM outpatient visits and inpatient services than the acalabrutinib and ibrutinib groups. This real-world study suggested that the zanubrutinib group demonstrated lower switching rates, longer time to discontinuation, improved compliance, and less healthcare resource use compared to the acalabrutinib and ibrutinib groups in patients with MCL.