Journal Article

Impact of the treatment of chronic myeloid leukaemia by tyrosine-kinase inhibitors on sick leaves refund: a nationwide cohort study

Vayr, Flora, Huguet, Françoise, Pajiep, Marie-Christelle, Conte, Cécile, Despas, Fabien, Herin, Fabrice, Gauthier, Martin, Mestre, Maryse Lapeyre

2022

Overview

Background The advent of chronic myeloid leukaemia (CML) tyrosine-kinase inhibitors (TKI) has led to new paradigms including occupational rehabilitation. Objectives This study aimed to characterize the impact of CML treatment on sick leaves within the 2 years following diagnosis in working-age patients. Methods A cohort of all 18–60-year-old newly diagnosed CML patients initiating a TKI between January 1 st 2011 and December 31 st 2014 in France was identified in the French National Healthcare database (Système National des Données de Santé [SNDS]). Patients with a sick leave identified in the 24 months after TKI initiation were compared with sex and initiation date matched controls in a nested case–control design. Factors associated with sick leaves were identified through a conditional logistic regression model, providing adjusted odds-ratio (OR) with their 95% confidence interval (CI). Results Among 646 18–60-year-old patients, 268 were prescribed at least one sick leave in the study period, with 176 (27.2%) having their first sick leave prescribed after TKI initiation. The median number of sick days over the 2-years period was 115 per patient (interquartile range 25.5–384.5). In the nested case–control study (176 cases and 176 matched controls), sick leaves were more likely observed with second generation TKI (OR 4.11 [1.80–9.38]), whereas they were less likely observed in case if social deprivation (OR 0.07 [0.02–0.28]. Conclusion More than 25% of working-age CML patients had at least one sick leave within 2 years of TKI initiation, with a higher impact of second generation TKI, and with a median duration of 115 days.

• Publisher: Springer Berlin Heidelberg,Springer,Springer Nature B.V,Springer Verlag (Germany)
• Subject: Adolescent / Adult / Age groups / Bosutinib / Cancer therapies / Case-Control Studies / Clinical outcomes / Cohort analysis / Cohort Studies / Comparative analysis / Deprivation / Health care / Health services / Humans / Inhibitor drugs / Leukemia / Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy / Life Sciences / Medical diagnosis / Medical ethics / Medicine / Medicine & Public Health / Middle Aged / Newly diagnosed / Nilotinib / Nursing / Nursing Research / Oncology / Original Article / Pain Medicine / Patients / Phenols / Protein Kinase Inhibitors - therapeutic use / Rehabilitation / Rehabilitation Medicine / Second generation / Sick Leave / Social isolation / Tyrosine / Young Adult