Real-world venetoclax dosing patterns and treatment persistence in patients with acute myeloid leukemia: a community pharmacy database study in Japan.

Venetoclax (VEN)-based regimens are widely used for patients with acute myeloid leukemia (AML) who are ineligible for intensive chemotherapy, but VEN dosing patterns and their relation to treatment persistence are not well described. We conducted a retrospective longitudinal study using de-identified dispensing records from Japanese community pharmacies to characterize VEN dosing patterns and treatment persistence in routine practice. Patients (n = 162) were clustered by mean daily VEN dose and dosing frequency, yielding four groups defined by high versus low dose and high versus low frequency. Treatment persistence was longer in the low-frequency clusters, where there was a clearer association with dosing frequency than with mean daily dose. Strong CYP3A4 inhibitor use was more common in low-dose clusters, consistent with dose adjustment when strong inhibitors are coadministered. These findings highlight heterogeneous real-world VEN use and its implications for treatment persistence.