Changes in Sézary Syndrome Treatment Patterns Amid Pandemic

The use of extracorporeal photopheresis and oral systemic agents declined in patients with Sézary syndrome as the COVID-19 pandemic began in spring 2020.

Yang Zhao, PhD, of Kyowa Kirin, Inc., and colleagues, conducted the study and presented their findings at the 10^th Annual Meeting of the Society of Hematologic Oncology (SOHO), where they received an honorable distinction award from SOHO for their poster on the study.

The researchers wanted to study real-world treatment patterns of patients with Sézary syndrome, a rare but aggressive type of cutaneous T-cell lymphoma (CTCL), as there are currently limited data on this due to the rarity of the syndrome.

“Furthermore, recent approvals of new agents for patients with CTCL as well as COVID-19 likely impacted real-world treatment patterns,” the researchers wrote.

The researchers classified patients who were treated between 2018 and 2020 by their year of diagnosis, 2018 (n=869), 2019 (n=882), or 2020 (n=853).

The overall use of systemic therapy increased from 2018 (41.8%) to 2020 (46.5%). During those years, parenteral systemic therapy increased from 20.7% in 2018 to 28.7% in 2020, but there was a lower use of it in the last quarter of 2020 compared with the third quarter of 2020.

The use of extracorporeal photopheresis declined from 17% in 2018 to 13.5% in 2020, but extracorporeal photopheresis use declined each quarter in 2019 and 2020, with a “notable drop” in the second quarter of 2020, the researchers reported. Oral systemic use dropped in the second quarter of 2020, but an increased-use trend in the third and fourth quarter of 2020.

The most prescribed systemic therapies from 2019 to 2020 were extracorporeal photopheresis, mogamulizumab, and bexarotene. However, mogamulizumab was the only systemic therapy with increased usage over time.

The overall use of skin-directed therapy increased from 48.9% in 2018 to 52.9% in 2020, with topical skin-directed therapy use increasing from 42.3% in 2018 to 48.3%. The use of skin-directed phototherapy declined from 6.3% in 2018 to 4.1% in 2020.

“This claims analysis indicated increased use in systemic and [skin-directed therapy] among patients [with Sézary syndrome] in 2018-2020,” Dr. Zhao and colleagues concluded. “The quarterly analysis indicated that the drop in [extracorporeal photopheresis] and oral systemic usage in [the second quarter of] 2020 coincided with the onset of the pandemic, but there was a stable use of parenteral systemic during 2020.”

Reference

Zhao Y, Tang J, Zhou H, et al. Real-world treatment patterns in patients with Sézary syndrome in the United States and the impact of covid-19. Abstract #TCL-458. Presented at the 10th Annual Meeting of the Society of Hematologic Oncology, September 28-October 1, 2022.