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NCT01566695 · OUTCOME

Percentage of Participants With an Erythroid Hematological Improvement (HI-E) Response According to 2006 IWG Criteria

The Efficacy and Safety of Oral Azacitidine Plus Best Supportive Care Versus Placebo and Best Supportive Care in Subjects With Red Blood Cell (RBC) Transfusion-Dependent Anemia and Thrombocytopenia Due to International Prognostic Scoring System (IPSS) Low Risk Myelodysplastic Syndrome (MDS) · Source last updated 2025-01-07

Results reported by the registry submitting party. Population, time horizon, units and missing values must be read together.

Measure
NUMBER
Unit
Percentage of Participants
Interval / dispersion
95% Confidence Interval
Time frame
From the date of randomization of study drug up to the treatment period; up to the data cut-off date of 25 January 2019; median duration of treatment to oral azacitidine was 5.29 months and 5.36 months for placebo

What was measured

Erythroid HI-E improvement was defined as a hemoglobin increase of ≥ 1.5 g/dL; or a reduction in units of RBC transfusions by an absolute number of at least 4 RBC transfusions/8 weeks compared with the pretreatment transfusion number in the previous 8 weeks. Only RBC transfusions given for a hemoglobin of ≤ 9.0 g/dL on treatment were counted in the RBC transfusion response evaluation.

Analysis population: The ITT population included all participants who were randomized, regardless of whether they received treatment or not.

Groups in this outcome

Oral Azacitidine and Best Supportive Care

Participants received 300 mg oral azacitidine tablets daily on days 1 to 21 of each 28-day treatment cycle and BSC included and was not limited to pRBC (packed red blood cell \[pRBC\] and whole blood), platelet transfusions (single donor or pooled donor), antibiotic, antiviral and/or antifungal therapy, nutritional support, and granulocyte colony stimulating factors (G-CSF) for participants who experienced neutropenic fever/infections.

Placebo Plus Best Supportive Care

Participants received identically matching placebo tablets QD on days 1 to 21 of each 28-day treatment cycle and BSC which included but was not limited to, pRBC and whole blood, platelet transfusions (single donor or pooled donor), antibiotic, antiviral and/or antifungal therapy, nutritional support, and G-CSF for participants who experienced neutropenic fever/infections.

Group identifiers and denominators belong to this outcome only. They may differ in another outcome or in safety reporting.

Analysis denominator · Participants

GroupSource count
Oral Azacitidine and Best Supportive Care107
Placebo Plus Best Supportive Care109

Reported measurements

HI-E Response
Values in Percentage of Participants · Interval/dispersion: 95% Confidence Interval
GroupValueSpreadLowerUpperComment
Oral Azacitidine and Best Supportive Care43.0Not reported33.652.4Not reported
Placebo Plus Best Supportive Care32.1Not reported23.340.9Not reported
≥ 1.5 g/dL Hemoglobin Increase
Values in Percentage of Participants · Interval/dispersion: 95% Confidence Interval
GroupValueSpreadLowerUpperComment
Oral Azacitidine and Best Supportive Care23.4Not reported15.331.4Not reported
Placebo Plus Best Supportive Care5.5Not reported1.29.8Not reported
RBC Transfusion Reduction
Values in Percentage of Participants · Interval/dispersion: 95% Confidence Interval
GroupValueSpreadLowerUpperComment
Oral Azacitidine and Best Supportive Care42.1Not reported32.751.4Not reported
Placebo Plus Best Supportive Care31.2Not reported22.539.9Not reported

Source statistical analyses

Group order, estimate direction, methods and comments are retained. No treatment ranking is inferred.

  1. ci Lower Limit
    -2.0
    ci Num Sides
    TWO_SIDED
    ci Pct Value
    95
    ci Upper Limit
    23.7
    group Ids
    1. OG000
    2. OG001
    non Inferiority Comment
    HI-E
    non Inferiority Type
    SUPERIORITY
    p Value
    0.1467
    param Type
    Rate Difference
    param Value
    10.9
    statistical Comment
    Stratified by average BL RBC tfx needs: ≤4 units versus \>4 units; BL platelet tfx status: dependent or independent and ECOG PS: 0 to 1 vs 2
    statistical Method
    Stratified Mantel-Haenszel. Chi-squared
  2. ci Lower Limit
    8.8
    ci Num Sides
    TWO_SIDED
    ci Pct Value
    95
    ci Upper Limit
    26.9
    group Ids
    1. OG000
    2. OG001
    non Inferiority Comment
    ≥ 1.5 g/dL Hemoglobin Increase
    non Inferiority Type
    SUPERIORITY
    p Value
    0.0002
    param Type
    Rate Diffrence
    param Value
    17.9
    statistical Comment
    Stratified by average BL RBC tfx needs: ≤4 units versus \>4 units; BL platelet tfx status: dependent or independent and ECOG PS: 0 to 1 vs 2
    statistical Method
    Stratified Mantel-Haenszel. Chi-squared
  3. ci Lower Limit
    -1.9
    ci Num Sides
    TWO_SIDED
    ci Pct Value
    95
    ci Upper Limit
    23.6
    group Ids
    1. OG000
    2. OG001
    non Inferiority Comment
    RBC Transfusion Reduction
    non Inferiority Type
    SUPERIORITY
    p Value
    0.1431
    param Type
    Rate Difference
    param Value
    10.9
    statistical Comment
    Stratified by average BL RBC tfx needs: ≤4 units versus \>4 units; BL platelet tfx status: dependent or independent and ECOG PS: 0 to 1 vs 2
    statistical Method
    Stratified Mantel-Haenszel. Chi-squared
Complete source fields
analyses
  1. ci Lower Limit
    -2.0
    ci Num Sides
    TWO_SIDED
    ci Pct Value
    95
    ci Upper Limit
    23.7
    group Ids
    1. OG000
    2. OG001
    non Inferiority Comment
    HI-E
    non Inferiority Type
    SUPERIORITY
    p Value
    0.1467
    param Type
    Rate Difference
    param Value
    10.9
    statistical Comment
    Stratified by average BL RBC tfx needs: ≤4 units versus \>4 units; BL platelet tfx status: dependent or independent and ECOG PS: 0 to 1 vs 2
    statistical Method
    Stratified Mantel-Haenszel. Chi-squared
  2. ci Lower Limit
    8.8
    ci Num Sides
    TWO_SIDED
    ci Pct Value
    95
    ci Upper Limit
    26.9
    group Ids
    1. OG000
    2. OG001
    non Inferiority Comment
    ≥ 1.5 g/dL Hemoglobin Increase
    non Inferiority Type
    SUPERIORITY
    p Value
    0.0002
    param Type
    Rate Diffrence
    param Value
    17.9
    statistical Comment
    Stratified by average BL RBC tfx needs: ≤4 units versus \>4 units; BL platelet tfx status: dependent or independent and ECOG PS: 0 to 1 vs 2
    statistical Method
    Stratified Mantel-Haenszel. Chi-squared
  3. ci Lower Limit
    -1.9
    ci Num Sides
    TWO_SIDED
    ci Pct Value
    95
    ci Upper Limit
    23.6
    group Ids
    1. OG000
    2. OG001
    non Inferiority Comment
    RBC Transfusion Reduction
    non Inferiority Type
    SUPERIORITY
    p Value
    0.1431
    param Type
    Rate Difference
    param Value
    10.9
    statistical Comment
    Stratified by average BL RBC tfx needs: ≤4 units versus \>4 units; BL platelet tfx status: dependent or independent and ECOG PS: 0 to 1 vs 2
    statistical Method
    Stratified Mantel-Haenszel. Chi-squared
classes
  1. categories
    1. measurements
      1. group Id
        OG000
        lower Limit
        33.6
        upper Limit
        52.4
        value
        43.0
      2. group Id
        OG001
        lower Limit
        23.3
        upper Limit
        40.9
        value
        32.1
    title
    HI-E Response
  2. categories
    1. measurements
      1. group Id
        OG000
        lower Limit
        15.3
        upper Limit
        31.4
        value
        23.4
      2. group Id
        OG001
        lower Limit
        1.2
        upper Limit
        9.8
        value
        5.5
    title
    ≥ 1.5 g/dL Hemoglobin Increase
  3. categories
    1. measurements
      1. group Id
        OG000
        lower Limit
        32.7
        upper Limit
        51.4
        value
        42.1
      2. group Id
        OG001
        lower Limit
        22.5
        upper Limit
        39.9
        value
        31.2
    title
    RBC Transfusion Reduction
denoms
  1. counts
    1. group Id
      OG000
      value
      107
    2. group Id
      OG001
      value
      109
    units
    Participants
description
Erythroid HI-E improvement was defined as a hemoglobin increase of ≥ 1.5 g/dL; or a reduction in units of RBC transfusions by an absolute number of at least 4 RBC transfusions/8 weeks compared with the pretreatment transfusion number in the previous 8 weeks. Only RBC transfusions given for a hemoglobin of ≤ 9.0 g/dL on treatment were counted in the RBC transfusion response evaluation.
dispersion Type
95% Confidence Interval
groups
  1. description
    Participants received 300 mg oral azacitidine tablets daily on days 1 to 21 of each 28-day treatment cycle and BSC included and was not limited to pRBC (packed red blood cell \[pRBC\] and whole blood), platelet transfusions (single donor or pooled donor), antibiotic, antiviral and/or antifungal therapy, nutritional support, and granulocyte colony stimulating factors (G-CSF) for participants who experienced neutropenic fever/infections.
    id
    OG000
    title
    Oral Azacitidine and Best Supportive Care
  2. description
    Participants received identically matching placebo tablets QD on days 1 to 21 of each 28-day treatment cycle and BSC which included but was not limited to, pRBC and whole blood, platelet transfusions (single donor or pooled donor), antibiotic, antiviral and/or antifungal therapy, nutritional support, and G-CSF for participants who experienced neutropenic fever/infections.
    id
    OG001
    title
    Placebo Plus Best Supportive Care
param Type
NUMBER
population Description
The ITT population included all participants who were randomized, regardless of whether they received treatment or not.
reporting Status
POSTED
time Frame
From the date of randomization of study drug up to the treatment period; up to the data cut-off date of 25 January 2019; median duration of treatment to oral azacitidine was 5.29 months and 5.36 months for placebo
title
Percentage of Participants With an Erythroid Hematological Improvement (HI-E) Response According to 2006 IWG Criteria
type
SECONDARY
unit Of Measure
Percentage of Participants

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