AI Article Synopsis

  • Tyrosine kinase inhibitors (TKIs) significantly improve chronic myeloid leukemia (CML) outcomes, but 20-30% of patients experience suboptimal responses and may need second-line treatments.
  • A pilot study in North India examined the effectiveness of adding pioglitazone to TKIs for these patients, ruling out imatinib resistance.
  • Results showed that 89.7% of participants experienced a one-log reduction, with high progression-free survival rates over a 3-year period, and no significant adverse events from pioglitazone, suggesting it could be a beneficial addition in resource-limited settings.

Article Abstract

Unlabelled: Tyrosine kinase inhibitors (TKIs) have improved outcomes of chronic myeloid leukemia (CML). However, 20-30% of patients require second-line TKIs following suboptimal response. The cost and adverse events limit their use in resource-constraint settings. We conducted a pilot study to ascertain the benefit of adding pioglitazone to TKIs with suboptimal response in real-world resource-constraint settings. In this pragmatic pilot study from 01 Jan 2017 to 31 July 2021, CML patients from a tertiary care center in North India with sub-optimal response to TKIs were additionally given pioglitazone after ruling out imatinib resistance mutation (n - 31). Pioglitazone was stopped if there was disease progression on follow-up, and second-line TKI was started. The data were analyzed with the intention-to-treat principle using JMP Ver.15.1.1. The median age of the study population was 54y (27-82), who were followed up for a median duration of 1023.5d (59-1117). Pioglitazone showed the benefit of one-log reduction in in 89.7% of the study participants. 1y, 2y and 3y-PFS were 92.57%, 76.5%, and 68.3% respectively. During follow-up period, the disease progressed in 38.7%, of which two succumbed. No adverse events to Pioglitazone were documented. This study proved that adding Pioglitazone to the existing TKI regime in CML with sub-optimal response can benefit. The addition of Pioglitazone was well tolerated.

Supplementary Information: The online version contains supplementary material available at 10.1007/s12288-022-01561-x.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868211PMC
http://dx.doi.org/10.1007/s12288-022-01561-xDOI Listing

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