title: Comparative analysis between azacitidine and decitabine for the treatment of myelodysplastic syndromes.
abstract: The present study aimed to directly compare the efficacy and safety of azacitidine and decitabine in patients with myelodysplastic syndromes (MDS). We compared the overall response rate (ORR) (complete responses, partial responses, marrow complete responses, and haematological improvements), overall survival (OS), event-free survival (EFS), time to leukaemic transformation, and adverse outcomes between azacitidine and decitabine. To minimize the effects of treatment selection bias in this observational study, adjustments were made using the propensity-score matching method. Among 300 patients, 203 were treated with azacitidine and 97 with decitabine. Propensity-score matching yielded 97 patient pairs. In the propensity-matched cohort, there were no significant differences between the azacitidine and decitabine groups regarding ORR (44% vs. 52%), OS (26 vs. 22.9 months), EFS (7.7 vs. 7.0 months), and rate of leukaemic transformation (16% vs. 22% at 1 year). In patients ≥ 65 years of age, survival was significantly better in the azacitidine group (P = 0.017). Patients who received decitabine experienced more frequent episodes of grade 3 or 4 cytopenia and infectious episodes. We found that azacitidine and decitabine showed comparable efficacy. Among patients ≥ 65 years of age, survival was significantly better in the azacitidine group (ClinicalTrials.gov Identifier: NCT01409070).
authors: Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors: Yun-Gyoo
authors: YG
authors: Lee
authors: Inho
authors: I
authors: Kim
authors: Sung-Soo
authors: SS
authors: Yoon
authors: Seonyang
authors: S
authors: Park
authors: June Won
authors: JW
authors: Cheong
authors: Yoo Hong
authors: YH
authors: Min
authors: Jeong-Ok
authors: JO
authors: Lee
authors: Soo-Mee
authors: SM
authors: Bang
authors: Hyeon Gyu
authors: HG
authors: Yi
authors: Chul Soo
authors: CS
authors: Kim
authors: Yong
authors: Y
authors: Park
authors: Byung-Soo
authors: BS
authors: Kim
authors: Yeung-Chul
authors: YC
authors: Mun
authors: Chu-Myoung
authors: CM
authors: Seong
authors: Jinny
authors: J
authors: Park
authors: Jae Hoon
authors: JH
authors: Lee
authors: Sung-Yong
authors: SY
authors: Kim
authors: Hong Ghi
authors: HG
authors: Lee
authors: Yeo-Kyeoung
authors: YK
authors: Kim
authors: Hyeoung-Joon
authors: HJ
authors: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000963:Antimetabolites / Q000009:adverse effects / Q000627:therapeutic use*; D001374:Azacitidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D001856:Bone Marrow Examination; D000077209:Decitabine; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D017053:Infection Control; D053208:Kaplan-Meier Estimate; D007621:Karyotyping; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000145:classification / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D009503:Neutropenia / Q000139:chemically induced; D012107:Research Design; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000963:Antimetabolites; D000077209:Decitabine; D001374:Azacitidine