Table 2.
Select characteristics of new users of palbociclib-fulvestrant and new users of fulvestrant monotherapy (historical comparator group) before and after propensity score matching
| Characteristicsa | Before Propensity Score Matching | After Propensity Score Matchingb | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| New users of palbociclib-fulvestrant | New users of fulvestrant monotherapy (pre-2015) | Std. difference | New users of palbociclib-fulvestrant | New users of fulvestrant monotherapy (pre-2015) | Std. difference | |||||
| N/Mean | %/SD | N/Mean | %/SD | N/Mean | %/SD | N/Mean | %/SD | |||
| Overall | 566 | 100% | 2316 | 100% | 561 | 100% | 561 | 100% | ||
| Total duration of follow-up (in years) | 324 | 1686 | 322 | 373 | ||||||
| Demographics | ||||||||||
| Age at index date (in years) | 59.3 | 11.0 | 64.1 | 12.9 | 0.4 | 59.5 | 11.0 | 59.9 | 13.3 | 0.04 |
| Sex | ||||||||||
| Male | ≤10 | n/a | 30 | 1.30 | 0.0 | ≤10 | n/a | ≤10 | n/a | 0.10 |
| Female | 557 | 98.4 | 2286 | 98.7 | 0.0 | 552 | 98.4 | 558 | 99.5 | 0.10 |
| Geographic region of residence | ||||||||||
| Midwest | 95 | 16.8 | 422 | 18.2 | 0.04 | 95 | 16.9 | 93 | 16.6 | 0.01 |
| South | 159 | 28.1 | 690 | 29.8 | 0.04 | 157 | 28.0 | 165 | 29.4 | 0.03 |
| Northeast | 166 | 29.3 | 580 | 25.0 | 0.10 | 164 | 29.2 | 158 | 28.2 | 0.02 |
| West | 146 | 25.8 | 624 | 26.9 | 0.03 | 145 | 25.8 | 145 | 25.8 | 0.00 |
| Medical History | ||||||||||
| Other primary cancer prior to first breast cancer diagnosis code | 223 | 39.4 | 1026 | 44.3 | 0.1 | 222 | 39.6 | 271 | 48.3 | 0.18 |
| Secondary malignancy (metastasis) | 496 | 87.6 | 1823 | 78.7 | 0.2 | 491 | 87.5 | 488 | 87.0 | 0.02 |
| Lymph nodes of head, face, and neck | 154 | 27.2 | 476 | 20.6 | 0.2 | 151 | 26.9 | 150 | 26.7 | 0.00 |
| Respiratory and digestive systems | 257 | 45.4 | 781 | 33.7 | 0.2 | 254 | 45.3 | 252 | 44.9 | 0.01 |
| Other specified sites | 463 | 81.8 | 1710 | 73.8 | 0.2 | 458 | 81.6 | 458 | 81.6 | 0.00 |
| Deyo-Charlson comorbidity index (DCI) without cancer codes | 8.5 | 1.8 | 7.85 | 2.3 | 0.3 | 8.5 | 1.8 | 8.56 | 1.6 | 0.03 |
| Cancer Therapy History | ||||||||||
| Radiation therapy | 112 | 19.8 | 386 | 16.7 | 0.1 | 112 | 20.0 | 117 | 20.9 | 0.02 |
| Surgery | 11 | 1.9 | 68 | 2.9 | 0.1 | 11 | 2.0 | 13 | 2.3 | 0.02 |
| Chemotherapy | 100 | 17.7 | 429 | 18.5 | 0.0 | 99 | 17.6 | 98 | 17.5 | 0.00 |
| Imaging | ||||||||||
| CT related imaging in the last 6 months | 139 | 24.6 | 501 | 21.6 | 0.1 | 138 | 24.6 | 146 | 26.0 | 0.03 |
| Diagnostic imaging in the last 6 months | 72 | 12.7 | 461 | 19.9 | 0.2 | 72 | 12.8 | 79 | 14.1 | 0.04 |
| MRI related imaging | 25 | 4.4 | 91 | 3.9 | 0.0 | 25 | 4.5 | 26 | 4.6 | 0.01 |
| Healthcare Utilization (6 months prior to index date) | ||||||||||
| Number of outpatient visits | 37.6 | 21.7 | 36.5 | 24.6 | 0.0 | 37.7 | 21.8 | 39.3 | 24.2 | 0.07 |
| Number of inpatient hospitalizations | 0.3 | 0.7 | 0.3 | 0.7 | 0.0 | 0.3 | 0.7 | 0.4 | 0.8 | 0.14 |
| Number of emergency department visits | 0.3 | 0.8 | 0.2 | 0.6 | 0.1 | 0.3 | 0.8 | 0.3 | 0.7 | 0.03 |
| Medication Use (breast cancer related) | ||||||||||
| Palbociclib | 0 | 0.00 | 0 | 0.00 | n/a | 0 | 0.00 | 0 | 0.00 | n/a |
| Aromatase inhibitor | 326 | 57.6 | 1285 | 55.5 | 0.04 | 321 | 57.2 | 303 | 54.0 | 0.06 |
| Letrozole | 116 | 20.5 | 429 | 18.5 | 0.05 | 113 | 20.1 | 116 | 20.7 | 0.01 |
| Anastrazole | 136 | 24.0 | 611 | 26.4 | 0.05 | 135 | 24.1 | 138 | 24.6 | 0.01 |
| Exemestane | 86 | 15.2 | 358 | 15.5 | 0.01 | 85 | 15.2 | 76 | 13.5 | 0.05 |
| HER2 positive therapy | 15 | 2.7 | 127 | 5.5 | 0.14 | 15 | 2.7 | 14 | 2.5 | 0.01 |
| Trastuzumab | 25 | 4.4 | 159 | 6.9 | 0.11 | 24 | 4.3 | 27 | 4.8 | 0.03 |
| Lapatinib | ≤10 | n/a | 16 | 0.7 | 0.05 | ≤10 | n/a | ≤10 | n/a | 0.03 |
| Ado-trastuzumab | 0 | 0.0 | 0 | 0.0 | n/a | 0 | 0.0 | 0 | 0.0 | n/a |
| Pertuzumab | 0 | 0.0 | 0 | 0.0 | n/a | 0 | 0.0 | 0 | 0.0 | n/a |
| Tamoxifen | 140 | 24.7 | 379 | 16.4 | 0.21 | 140 | 25.0 | 135 | 24.1 | 0.02 |
| Fulvestrant | 238 | 42.0 | 0 | 0.0 | n/a | 236 | 42.1 | 0 | 0.0 | n/a |
| Denosumab or Pamidronate | 206 | 36.4 | 424 | 18.3 | 0.41 | 201 | 35.8 | 197 | 35.1 | 0.01 |
| Everolimus | 40 | 7.1 | 84 | 3.6 | 0.15 | 39 | 7.0 | 37 | 6.6 | 0.01 |
| Medication Use (not breast cancer related) | ||||||||||
| Anticonvulsants | 126 | 22.3 | 347 | 15.0 | 0.19 | 122 | 21.7 | 123 | 21.9 | 0.00 |
| Antidepressants | 178 | 31.4 | 631 | 27.2 | 0.09 | 175 | 31.2 | 184 | 32.8 | 0.03 |
| Antihypertensives | 173 | 30.6 | 623 | 26.9 | 0.08 | 171 | 30.5 | 135 | 24.1 | 0.14 |
| Antimycobacterials | 109 | 19.3 | 446 | 19.3 | 0.00 | 107 | 19.1 | 117 | 20.9 | 0.04 |
| Antivirals | 32 | 5.7 | 112 | 4.8 | 0.04 | 32 | 5.7 | 30 | 5.3 | 0.02 |
| Corticosteroids | 148 | 26.1 | 416 | 18.0 | 0.20 | 146 | 26.0 | 146 | 26.0 | 0.00 |
| Lipid lowering agent | 132 | 23.3 | 556 | 24.0 | 0.02 | 130 | 23.2 | 121 | 21.6 | 0.04 |
| Sedatives/hypnotics | 57 | 10.1 | 291 | 12.6 | 0.08 | 57 | 10.2 | 63 | 11.2 | 0.03 |
| Co-morbidities (6 months prior to index date) | ||||||||||
| Pathologic fracture | 46 | 8.1 | 173 | 7.5 | 0.02 | 46 | 8.2 | 51 | 9.1 | 0.03 |
| Major adverse cardiac events (MACE) | 20 | 3.5 | 83 | 3.6 | 0.00 | 20 | 3.6 | 23 | 4.1 | 0.03 |
| Cerebrovascular disease | 301 | 53.2 | 1148 | 49.6 | 0.07 | 296 | 52.8 | 277 | 49.4 | 0.07 |
| Hyperglycemia | 27 | 4.8 | 55 | 2.4 | 0.13 | 23 | 4.1 | 29 | 5.2 | 0.05 |
| Deyo-Charlson Index (DCI) | ||||||||||
| 0–3 | 19 | 3.4 | 259 | 11.2 | 0.30 | 19 | 3.4 | 17 | 3.0 | 0.02 |
| 4–7 | 12 | 2.1 | 57 | 2.5 | 0.02 | 12 | 2.1 | 4 | 0.7 | 0.12 |
| 8–11 | 512 | 90.5 | 1937 | 83.6 | 0.20 | 508 | 90.6 | 517 | 92.2 | 0.06 |
| 12 or more | 23 | 4.1 | 63 | 2.7 | 0.07 | 22 | 3.9 | 23 | 4.1 | 0.01 |
| Risk factors associated with ALI | ||||||||||
| Chronic liver disease or Alcoholismc | 74 | 13.1 | 246 | 10.6 | 0.09 | 74 | 13.1 | 69 | 12.2 | 0.03 |
| Chronic or acute disease of gallbladder or pancreasc | 36 | 6.4 | 145 | 6.3 | 0.01 | 36 | 6.4 | 34 | 6.0 | 0.01 |
| Hepatic, Biliary or pancreatic cancerc | 160 | 28.3 | 458 | 19.8 | 0.18 | 160 | 28.3 | 143 | 25.3 | 0.07 |
| Congestive heart failurec | 29 | 5.1 | 159 | 6.9 | 0.07 | 29 | 5.1 | 29 | 5.1 | 0.00 |
| Any medication associated with liver failurec | 467 | 82.51 | 1749 | 75.52 | 0.17 | 466 | 82.48 | 466 | 82.48 | 0.00 |
| Acetaminophen (prescription) c | 204 | 36.04 | 899 | 38.82 | 0.06 | 204 | 36.11 | 202 | 35.75 | 0.01 |
Abbreviations: ER estrogen receptor, HER2 human epidermal growth factor receptor 2, N number, SD standard deviation, Std standardized, CT computed tomography, MRI magnetic resonance imaging
aAll characteristics are measured as presence within 6 months prior to the index date, unless otherwise specified
bThe following variables were included in the propensity score for all safety event analyses: age, region, Deyo-Charlson Index, number of outpatient visits, number of emergency room visits, secondary malignancy to lymph nodes of head, face, and neck, secondary malignancy to other specified sites, secondary malignancy to respiratory sites, tamoxifen, everolimus, anastrazole, denosumab or pamidronate, exemestane, chemotherapy, corticosteroids, diagnostic imaging, breast cancer surgery, letrozole, HER2 positive therapy, radiation therapy, CT imaging, mammography, MRI imaging, anticonvulsants, antidepressants, sedatives/hypnotics, secondary malignancy to breast, breast cancer diagnosis code, in situ breast cancer diagnosis, hyperglycemia, and cerebrovascular disease
cThe following variables were included in the propensity score specific for subsequent ALI analyses (conducted after observing an association with ALI in initial analyses): age, region, Deyo-Charlson Index, number of outpatient visits, number of emergency room visits, secondary malignancy to lymph nodes of head, face, and neck, secondary malignancy to other specified sites, secondary malignancy to respiratory sites, tamoxifen, everolimus, anastrazole, denosumab or pamidronate, exemestane, chemotherapy, corticosteroids, diagnostic imaging, breast cancer surgery, letrozole, HER2 positive therapy, radiation therapy, CT imaging, mammography, MRI imaging, anticonvulsants, antidepressants, sedatives/hypnotics, secondary malignancy to breast, breast cancer diagnosis code, in situ breast cancer diagnosis, hyperglycemia, cerebrovascular disease, Chronic liver disease or Alcoholism, Chronic or acute disease of gallbladder or pancreas, Hepatic, Biliary or pancreatic cancer, Congestive heart failure, any medication associated with ALI- Acetaminophen, Allopurinol, Amiodarone, Amitriptyline, + clavulanic acid, Aripiprazole, Baclofen, Ciprofloxacin, Clindamycin, Clopidogrel, Duloxetine, Estrogens, Fluoxetine, Ketoconazole, Lisinopril, Losartan, Mirtazapine, Nitrofurantoin, NSAIDs, Omeprazole, Paroxetine, Phenothiazine, Sertraline, Statins, Tetracycline, Trazodone, and Trimethoprim