Bortezomib Inpatient Prescribing Practices in Free-Standing Children's Hospitals in the United States

Abstract

This study is a pharmacoepidemiologic description of pediatric bortezomib use. Exposure was identified through billing codes in patients admitted to US children’s hospitals that participated with the Pediatric Health Information System between 2004 and 2013. Associated information on underlying diseases, demographics, institutional use, mortality, and physician type was collected. Exposure to bortezomib was identified in 314 patients. Hematologist/Oncologists prescribed half of the bortezomib used. Use increased during the study period. Inpatient volume was positively correlated with bortezomib utilization. Bortezomib use in pediatrics is increasing for a variety of diseases. Variation in use exists across institutions. Further studies are needed to characterize bortezomib’s efficacy in pediatric diseases.

Pre‐clinical evaluation of proteasome inhibitors for canine and human osteosarcoma

“…Of note, off-label use of bortezomib for pediatric patients is increasing: 46 pediatric hospitals in the United States each treated an average of 2 patients with bortezomib in 2013, mostly for cancer or transplant complications. 88 These observations reinforce the call by Zaman et al 89 for research into the long term effects of childhood proteasome inhibitor administration on bone growth and health.…”

“…None of these studies have unveiled any effect of proteasome inhibitors on participants' bones, but emergence of such late effects would not be expected given the short‐term nature of these trials (and the poor survival of many participants). Of note, off‐label use of bortezomib for pediatric patients is increasing: 46 pediatric hospitals in the United States each treated an average of 2 patients with bortezomib in 2013, mostly for cancer or transplant complications . These observations reinforce the call by Zaman et al for research into the long term effects of childhood proteasome inhibitor administration on bone growth and health.…”

Implementation science in pediatric oncology: A narrative review and future directions

“…With the proliferation of research networks such as the Pediatric Health Information System (PHIS) and PEDSnet, the infrastructure to address these pragmatic, “real‐world” questions will be available. PHIS has been utilized to conduct pediatric oncology research outside the clinical trials infrastructure to address topics such as racial inequities 29 and off‐study immunotherapy use 30 . Patients with leukemia and lymphoma have accurately been identified within PEDSnet 31 .…”

“…PHIS has been utilized to conduct pediatric oncology research outside the clinical trials infrastructure to address topics such as racial inequities 29 and off-study immunotherapy use. 30 Patients with leukemia and lymphoma have accurately been identified within PEDSnet. 31 However, the hospitals participating in both PHIS and PEDSnet tend to be large academic centers and do not include many community hospitals.…”