{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T18:28:05Z","timestamp":1781720885960,"version":"3.54.5"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T00:00:00Z","timestamp":1739145600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T00:00:00Z","timestamp":1739145600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Hematol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>There is little evidence, particularly in Germany, on the epidemiology and the cytoreductive management of polycythemia vera (PV). We performed an observational study based on anonymized health claims data to provide estimates of the epidemiology of PV in Germany, to describe the use of cytoreductive drugs in patients with PV, and to assess the occurrence of thromboembolic events (TEs) in prevalent patients on continuous treatment with relevant cytoreductive drugs over time. For the year 2021, we estimated a PV prevalence of 28.6 per 100,000 and an incidence of 3.3 per 100,000 in the German adult population (\u2265\u200918 years). We identified 83.2% of prevalent patients in 2021 as being at high risk for thromboembolic complications, based on age (\u2265\u200960 years) and\/or history of TEs. Contrary to treatment guidelines, 43.6% of these high-risk patients did not receive cytoreductive drug treatment in 2021. 63.5% of patients in 2021 who were treated with hydroxyurea (but not ruxolitinib) in that year, met our defined proxy criteria for intolerance\/resistance to hydroxyurea. Over time, we observed a lower proportion of patients with TEs in patients continuously treated with ruxolitinib compared to patients treated with hydroxyurea who also met our defined proxy criteria for intolerance\/resistance to hydroxyurea (35.8% vs. 56.3% after three years). Our findings suggest that currently available cytoreductive therapies are not being fully utilized according to treatment guidelines, which may lead to avoidable thromboembolic complications in this patient population.<\/jats:p>","DOI":"10.1007\/s00277-025-06192-6","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T00:57:31Z","timestamp":1739149051000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence, incidence, and thromboembolic events in polycythemia vera: a study based on longitudinal German health claims data"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8026-7447","authenticated-orcid":false,"given":"Karina C.","family":"Manz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Mocek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bashar","family":"Morouj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Merker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Feuerbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariane","family":"H\u00f6er","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Weber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raeleesha","family":"Norris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Grosser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Andersohn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haifa Kathrin","family":"Al-Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,10]]},"reference":[{"key":"6192_CR1","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1182\/blood.2018834044","volume":"134","author":"JL Spivak","year":"2019","unstructured":"Spivak JL (2019) How I treat polycythemia vera. Blood 134:341\u2013352. https:\/\/doi.org\/10.1182\/blood.2018834044","journal-title":"Blood"},{"key":"6192_CR2","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1159\/000509376","volume":"43","author":"S Mancuso","year":"2020","unstructured":"Mancuso S, Santoro M, Accurso V et al (2020) Cardiovascular Risk in Polycythemia Vera: thrombotic risk and survival: can Cytoreductive Therapy be useful in patients with low-risk Polycythemia Vera with Cardiovascular Risk factors? Oncol Res Treat 43:526\u2013530. https:\/\/doi.org\/10.1159\/000509376","journal-title":"Oncol Res Treat"},{"key":"6192_CR3","doi-asserted-by":"publisher","first-page":"694","DOI":"10.1080\/10428194.2021.1992756","volume":"63","author":"S Verstovsek","year":"2022","unstructured":"Verstovsek S, Yu J, Scherber RM et al (2022) Changes in the incidence and overall survival of patients with myeloproliferative neoplasms between 2002 and 2016 in the United States. Leuk Lymphoma 63:694\u2013702. https:\/\/doi.org\/10.1080\/10428194.2021.1992756","journal-title":"Leuk Lymphoma"},{"key":"6192_CR4","first-page":"31","volume":"22","author":"JA Waksal","year":"2024","unstructured":"Waksal JA, Wagner NE, Mascarenhas JO (2024) Risk factors for Disease Progression and Treatment goals in Polycythemia Vera. Clin Adv Hematol Oncol 22:31\u201342","journal-title":"Clin Adv Hematol Oncol"},{"key":"6192_CR5","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1111\/joim.13019","volume":"287","author":"M Hultcrantz","year":"2020","unstructured":"Hultcrantz M, Ravn Landtblom A, Andr\u00e9asson B et al (2020) Incidence of myeloproliferative neoplasms - trends by subgroup and age in a population-based study in Sweden. J Intern Med 287:448\u2013454. https:\/\/doi.org\/10.1111\/joim.13019","journal-title":"J Intern Med"},{"key":"6192_CR6","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1111\/ejh.12788","volume":"98","author":"C Roaldsnes","year":"2017","unstructured":"Roaldsnes C, Holst R, Frederiksen H et al (2017) Myeloproliferative neoplasms: trends in incidence, prevalence and survival in Norway. Eur J Haematol 98:85\u201393. https:\/\/doi.org\/10.1111\/ejh.12788","journal-title":"Eur J Haematol"},{"key":"6192_CR7","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1111\/ejh.12256","volume":"92","author":"O Moulard","year":"2014","unstructured":"Moulard O, Mehta J, Fryzek J et al (2014) Epidemiology of myelofibrosis, essential thrombocythemia, and polycythemia vera in the European Union. Eur J Haematol 92:289\u2013297. https:\/\/doi.org\/10.1111\/ejh.12256","journal-title":"Eur J Haematol"},{"key":"6192_CR8","unstructured":"Lengfelder E, Baerlocher GM, D\u00f6hner K et al (2023) Polycythaemia Vera (PV). https:\/\/www.onkopedia.com\/de\/onkopedia\/guidelines\/polycythaemia-vera-pv\/@@guideline\/html\/index.html"},{"key":"6192_CR9","doi-asserted-by":"publisher","first-page":"e301","DOI":"10.1016\/S2352-3026(22)00046-1","volume":"9","author":"M Marchetti","year":"2022","unstructured":"Marchetti M, Vannucchi AM, Griesshammer M et al (2022) Appropriate management of polycythaemia vera with cytoreductive drug therapy: European LeukemiaNet 2021 recommendations. Lancet Haematol 9:e301\u2013e311. https:\/\/doi.org\/10.1016\/S2352-3026(22)00046-1","journal-title":"Lancet Haematol"},{"key":"6192_CR10","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1002\/ajh.24851","volume":"92","author":"T Barbui","year":"2017","unstructured":"Barbui T, Vannucchi AM, Finazzi G et al (2017) A reappraisal of the benefit-risk profile of hydroxyurea in polycythemia vera: a propensity-matched study. Am J Hematol 92:1131\u20131136. https:\/\/doi.org\/10.1002\/ajh.24851","journal-title":"Am J Hematol"},{"key":"6192_CR11","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.1182\/blood-2011-10-387787","volume":"119","author":"A Alvarez-Larr\u00e1n","year":"2012","unstructured":"Alvarez-Larr\u00e1n A, Pereira A, Cervantes F et al (2012) Assessment and prognostic value of the European LeukemiaNet criteria for clinicohematologic response, resistance, and intolerance to hydroxyurea in polycythemia vera. Blood 119:1363\u20131369. https:\/\/doi.org\/10.1182\/blood-2011-10-387787","journal-title":"Blood"},{"key":"6192_CR12","doi-asserted-by":"publisher","first-page":"2441","DOI":"10.1002\/cncr.34195","volume":"128","author":"A Alvarez-Larr\u00e1n","year":"2022","unstructured":"Alvarez-Larr\u00e1n A, Garrote M, Ferrer-Mar\u00edn F et al (2022) Real-world analysis of main clinical outcomes in patients with polycythemia vera treated with ruxolitinib or best available therapy after developing resistance\/intolerance to hydroxyurea. Cancer 128:2441\u20132448. https:\/\/doi.org\/10.1002\/cncr.34195","journal-title":"Cancer"},{"key":"6192_CR13","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1111\/j.1365-2141.2009.08019.x","volume":"148","author":"G Barosi","year":"2010","unstructured":"Barosi G, Birgegard G, Finazzi G et al (2010) A unified definition of clinical resistance and intolerance to hydroxycarbamide in polycythaemia vera and primary myelofibrosis: results of a European LeukemiaNet (ELN) consensus process. Br J Haematol 148:961\u2013963. https:\/\/doi.org\/10.1111\/j.1365-2141.2009.08019.x","journal-title":"Br J Haematol"},{"key":"6192_CR14","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1586\/17474086.2015.1045869","volume":"8","author":"J-J Kiladjian","year":"2015","unstructured":"Kiladjian J-J, Winton EF, Talpaz M et al (2015) Ruxolitinib for the treatment of patients with polycythemia vera. Expert Rev Hematol 8:391\u2013401. https:\/\/doi.org\/10.1586\/17474086.2015.1045869","journal-title":"Expert Rev Hematol"},{"key":"6192_CR15","doi-asserted-by":"publisher","first-page":"3534","DOI":"10.1200\/JCO.22.01935","volume":"41","author":"CN Harrison","year":"2023","unstructured":"Harrison CN, Nangalia J, Boucher R et al (2023) Ruxolitinib Versus Best available therapy for Polycythemia Vera intolerant or resistant to Hydroxycarbamide in a Randomized Trial. J Clin Oncol 41:3534\u20133544. https:\/\/doi.org\/10.1200\/JCO.22.01935","journal-title":"J Clin Oncol"},{"key":"6192_CR16","doi-asserted-by":"publisher","first-page":"e226","DOI":"10.1016\/S2352-3026(19)30207-8","volume":"7","author":"J-J Kiladjian","year":"2020","unstructured":"Kiladjian J-J, Zachee P, Hino M et al (2020) Long-term efficacy and safety of ruxolitinib versus best available therapy in polycythaemia vera (RESPONSE): 5-year follow up of a phase 3 study. Lancet Haematol 7:e226\u2013e237. https:\/\/doi.org\/10.1016\/S2352-3026(19)30207-8","journal-title":"Lancet Haematol"},{"key":"6192_CR17","doi-asserted-by":"publisher","first-page":"821","DOI":"10.3324\/haematol.2016.143644","volume":"101","author":"S Verstovsek","year":"2016","unstructured":"Verstovsek S, Vannucchi AM, Griesshammer M et al (2016) Ruxolitinib versus best available therapy in patients with polycythemia vera: 80-week follow-up from the RESPONSE trial. Haematologica 101:821\u2013829. https:\/\/doi.org\/10.3324\/haematol.2016.143644","journal-title":"Haematologica"},{"key":"6192_CR18","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.puhe.2022.02.013","volume":"206","author":"M Ludwig","year":"2022","unstructured":"Ludwig M, Enders D, Basedow F et al (2022) Sampling strategy, characteristics and representativeness of the InGef research database. Public Health 206:57\u201362. https:\/\/doi.org\/10.1016\/j.puhe.2022.02.013","journal-title":"Public Health"},{"key":"6192_CR19","unstructured":"Federal Statistical Office (2021) Current population of Germany. https:\/\/www.destatis.de\/EN\/Themes\/Society-Environment\/Population\/Current-Population\/_node.html#1346190. Accessed 13 Dec 2024"},{"key":"6192_CR20","unstructured":"Orphanet Report Series (2023) Number 1 | November 2023 Prevalence and incidence of rare diseases: Bibliographic data: Prevalence, incidence or number of published cases listed by diseases (in alphabetical order). https:\/\/www.orpha.net\/orphacom\/cahiers\/docs\/GB\/Prevalence_of_rare_diseases_by_alphabetical_list.pdf. Accessed 05 Feb 2024"},{"key":"6192_CR21","volume-title":"EBM-Reform: \u00dcbersicht Der Auswirkungen Je Fachgruppe: Das Ist Neu ab 1","author":"K Bundesvereinigung","year":"2020","unstructured":"Bundesvereinigung K (2020) EBM-Reform: \u00dcbersicht der Auswirkungen je Fachgruppe. https:\/\/www.kbv.de\/media\/sp\/EBM-Reform__bersicht_Fachgruppen.pdf. Accessed 05 Feb 2024"},{"key":"6192_CR22","doi-asserted-by":"publisher","first-page":"2693","DOI":"10.1007\/s00432-021-03855-5","volume":"148","author":"CC Crodel","year":"2022","unstructured":"Crodel CC, Jentsch-Ullrich K, Reiser M et al (2022) Cytoreductive treatment in real life: a chart review analysis on 1440 patients with polycythemia vera. J Cancer Res Clin Oncol 148:2693\u20132705. https:\/\/doi.org\/10.1007\/s00432-021-03855-5","journal-title":"J Cancer Res Clin Oncol"},{"key":"6192_CR23","doi-asserted-by":"publisher","first-page":"2041","DOI":"10.1007\/s00432-016-2209-1","volume":"142","author":"K Jentsch-Ullrich","year":"2016","unstructured":"Jentsch-Ullrich K, Eberhardt J, Zeremski V et al (2016) Characteristics and treatment of polycythemia vera patients in clinical practice: a multicenter chart review on 1476 individuals in Germany. J Cancer Res Clin Oncol 142:2041\u20132049. https:\/\/doi.org\/10.1007\/s00432-016-2209-1","journal-title":"J Cancer Res Clin Oncol"},{"key":"6192_CR24","volume-title":"Demographic facts and trends in Germany, 2010\u20132020","author":"Federal Institute for Population Research","year":"2021","unstructured":"Federal Institute for Population Research (2021) Demographic facts and trends in Germany, 2010\u20132020. Report by the Federal Institute for Population Research (BiB). https:\/\/www.bib.bund.de\/Publikation\/2021\/pdf\/Demographic-facts-and-trends-in-Germany-2010-2020.pdf . Accessed 05 Feb 2024"},{"key":"6192_CR25","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1007\/s00277-019-03625-x","volume":"98","author":"M Griesshammer","year":"2019","unstructured":"Griesshammer M, Kiladjian J-J, Besses C (2019) Thromboembolic events in polycythemia vera. Ann Hematol 98:1071\u20131082. https:\/\/doi.org\/10.1007\/s00277-019-03625-x","journal-title":"Ann Hematol"},{"key":"6192_CR26","doi-asserted-by":"publisher","first-page":"2176","DOI":"10.1182\/blood-2013-03-460154","volume":"122","author":"T Barbui","year":"2013","unstructured":"Barbui T, Finazzi G, Falanga A (2013) Myeloproliferative neoplasms and thrombosis. Blood 122:2176\u20132184. https:\/\/doi.org\/10.1182\/blood-2013-03-460154","journal-title":"Blood"},{"key":"6192_CR27","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1038\/s41375-018-0077-1","volume":"32","author":"T Barbui","year":"2018","unstructured":"Barbui T, Tefferi A, Vannucchi AM et al (2018) Philadelphia chromosome-negative classical myeloproliferative neoplasms: revised management recommendations from European LeukemiaNet. Leukemia 32:1057\u20131069. https:\/\/doi.org\/10.1038\/s41375-018-0077-1","journal-title":"Leukemia"},{"key":"6192_CR28","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1056\/NEJMoa1208500","volume":"368","author":"R Marchioli","year":"2013","unstructured":"Marchioli R, Finazzi G, Specchia G et al (2013) Cardiovascular events and intensity of treatment in polycythemia vera. N Engl J Med 368:22\u201333. https:\/\/doi.org\/10.1056\/NEJMoa1208500","journal-title":"N Engl J Med"},{"key":"6192_CR29","doi-asserted-by":"publisher","first-page":"e915","DOI":"10.1016\/j.clml.2021.06.023","volume":"21","author":"I Altomare","year":"2021","unstructured":"Altomare I, Parasuraman S, Paranagama D et al (2021) Real-world dosing patterns of Ruxolitinib in patients with Polycythemia Vera who are resistant to or intolerant of Hydroxyurea. Clin Lymphoma Myeloma Leuk 21:e915\u2013e921. https:\/\/doi.org\/10.1016\/j.clml.2021.06.023","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"6192_CR30","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1002\/hon.2843","volume":"39","author":"G Benevolo","year":"2021","unstructured":"Benevolo G, Elli EM, Bartoletti D et al (2021) Impact of comorbidities and body mass index on the outcome of polycythemia vera patients. Hematol Oncol 39:409\u2013418. https:\/\/doi.org\/10.1002\/hon.2843","journal-title":"Hematol Oncol"},{"key":"6192_CR31","doi-asserted-by":"publisher","first-page":"e2020008","DOI":"10.4084\/MJHID.2020.008","volume":"12","author":"V Accurso","year":"2020","unstructured":"Accurso V, Santoro M, Mancuso S et al (2020) Cardiovascular Risk in essential thrombocythemia and Polycythemia Vera: thrombotic risk and survival. Mediterr J Hematol Infect Dis 12:e2020008. https:\/\/doi.org\/10.4084\/MJHID.2020.008","journal-title":"Mediterr J Hematol Infect Dis"},{"key":"6192_CR32","doi-asserted-by":"publisher","first-page":"1996","DOI":"10.1038\/s41375-019-0487-8","volume":"33","author":"T Barbui","year":"2019","unstructured":"Barbui T, Ghirardi A, Masciulli A et al (2019) Second cancer in Philadelphia negative myeloproliferative neoplasms (MPN-K). A nested case-control study. Leukemia 33:1996\u20132005. https:\/\/doi.org\/10.1038\/s41375-019-0487-8","journal-title":"Leukemia"},{"key":"6192_CR33","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1002\/ajh.23160","volume":"87","author":"E Antonioli","year":"2012","unstructured":"Antonioli E, Guglielmelli P, Pieri L et al (2012) Hydroxyurea-related toxicity in 3,411 patients with Ph\u2019-negative MPN. Am J Hematol 87:552\u2013554. https:\/\/doi.org\/10.1002\/ajh.23160","journal-title":"Am J Hematol"},{"key":"6192_CR34","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/j.clml.2019.09.601","volume":"20","author":"MR Grunwald","year":"2020","unstructured":"Grunwald MR, Kuter DJ, Altomare I et al (2020) Treatment patterns and blood counts in patients with Polycythemia Vera treated with Hydroxyurea in the United States: an analysis from the REVEAL Study. Clin Lymphoma Myeloma Leuk 20:219\u2013225. https:\/\/doi.org\/10.1016\/j.clml.2019.09.601","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"6192_CR35","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1111\/ejh.13022","volume":"100","author":"T Devos","year":"2018","unstructured":"Devos T, Beguin Y, Noens L et al (2018) Disease and treatment characteristics of polycythemia vera patients in Belgium: results from a scientific survey. Eur J Haematol 100:361\u2013366. https:\/\/doi.org\/10.1111\/ejh.13022","journal-title":"Eur J Haematol"},{"key":"6192_CR36","doi-asserted-by":"publisher","first-page":"3706","DOI":"10.3390\/cancers15143706","volume":"15","author":"F Palandri","year":"2023","unstructured":"Palandri F, Rossi E, Auteri G et al (2023) Predictors of response to Hydroxyurea and switch to Ruxolitinib in HU-Resistant Polycythaemia VERA patients: a real-world PV-NET study. Cancers 15:3706. https:\/\/doi.org\/10.3390\/cancers15143706","journal-title":"Cancers"},{"key":"6192_CR37","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1111\/bjh.13886","volume":"172","author":"A Alvarez-Larr\u00e1n","year":"2016","unstructured":"Alvarez-Larr\u00e1n A, Kerguelen A, Hern\u00e1ndez-Boluda JC et al (2016) Frequency and prognostic value of resistance\/intolerance to hydroxycarbamide in 890 patients with polycythaemia vera. Br J Haematol 172:786\u2013793. https:\/\/doi.org\/10.1111\/bjh.13886","journal-title":"Br J Haematol"},{"key":"6192_CR38","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1056\/NEJMoa1409002","volume":"372","author":"AM Vannucchi","year":"2015","unstructured":"Vannucchi AM, Kiladjian JJ, Griesshammer M et al (2015) Ruxolitinib versus standard therapy for the treatment of polycythemia vera. N Engl J Med 372:426\u2013435. https:\/\/doi.org\/10.1056\/NEJMoa1409002","journal-title":"N Engl J Med"},{"key":"6192_CR39","unstructured":"European Medicines Agency (2024) Jakavi ruxolitinib. https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/jakavi. Accessed 16 Feb 2024"},{"key":"6192_CR40","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1038\/s41408-017-0042-7","volume":"8","author":"A Tefferi","year":"2018","unstructured":"Tefferi A, Vannucchi AM, Barbui T (2018) Polycythemia vera treatment algorithm 2018. Blood cancer J 8:3. https:\/\/doi.org\/10.1038\/s41408-017-0042-7","journal-title":"Blood cancer J"}],"container-title":["Annals of Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00277-025-06192-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00277-025-06192-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00277-025-06192-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T12:57:32Z","timestamp":1739192252000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00277-025-06192-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,10]]},"references-count":40,"alternative-id":["6192"],"URL":"https:\/\/doi.org\/10.1007\/s00277-025-06192-6","relation":{},"ISSN":["0939-5555","1432-0584"],"issn-type":[{"value":"0939-5555","type":"print"},{"value":"1432-0584","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,10]]},"assertion":[{"value":"23 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 February 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was funded by Novartis Pharma GmbH. The authors had complete autonomy for the process of designing the study, carrying out the analyses, interpreting the results, and preparing the manuscript. This also includes the full right to publish the results without limitation.\u00a0KCM and AH are employees of the IGES Institut GmbH, which is a paid consultant to Novartis Pharma GmbH for conducting the study and preparing the manuscript. At the time of this study, VW and AM were employees of the IGES Institut GmbH. BM and RN are employees of the InGef \u2013 Institute for Applied Health Research Berlin GmbH, which was contracted and reimbursed by IGES Institut GmbH for providing the data and carrying out the analyses.KM, MF, and SG are employees of Novartis Pharma GmbH.FA received consulting fees from Abbott, Almirall, AstraZeneca, Berlin-Chemie, Boehringer Ingelheim, InGef, Lundbeck, Novartis, NovoNordisk, Shire, and Xcenda.HKA received research support from Bristol-Myers Squibb, Incyte, and Novartis, consulting fees from AbbVie, AOP Health, Bristol-Myers Squibb, GSK, Novartis, and Otsuka, advisory board fees from AbbVie, AOP Health, Blueprint, Bristol-Myers Squibb, GSK, and Novartis, and a travel grant from Alexion.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Since all patient-level data in the database are anonymized to comply with German data protections regulations and German federal law, approval of an Ethics Committee was not required. The research was conducted in accordance with the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Since anonymized administrative claims data were used and presented only in aggregate form, informed consent of patients was not required. The pre-existing database did not allow direct identification of patients, and no contact was made with patients.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Patient consent statement"}}]}}