Whether Ponatinib, as a third-generation BCR-ABL tyrosine kinase inhibitor, is marketed in China is an important information that patients want to obtain, and whether it can be taken for a long time is also a topic of close concern for patients.

1. Listing situation in China

(1) First approval date: In June 2020, it was approved for import by the National Medical Products Administration (NMPA) of China for the treatment of specific CML patients.

(2) Medical insurance inclusion: In 2021, it was included in the medical insurance catalog through national medical insurance negotiations, significantly improving the accessibility of medication.

Feasibility of long-term medication

(1) Punatinib, as a tyrosine kinase inhibitor, can theoretically be used for a long time to continuously inhibit tumor progression.

(2) The actual medication cycle needs to be individualized, and the median treatment time in clinical trials is about 12-24 months.

3 Monitoring requirements for long-term medication use

(1) Cardiovascular monitoring: Monitor blood pressure at least monthly and regularly assess the risk of arterial thrombosis.

(2) Liver function monitoring: Testing every 2 weeks for the first 4 weeks of treatment, followed by monthly or clinical follow-up as needed.

(3) Hematological monitoring: Check the whole blood cell count weekly until the condition stabilizes.

Risk management for long-term medication

(1) Arterial thrombosis: The incidence increases with prolonged medication time and requires assessment of underlying cardiovascular diseases.

(2) Abnormal liver function: About 30% of patients experience elevated transaminase levels and require timely adjustment of dosage.

(3) Pancreatitis: Regularly test serum lipase and stop medication immediately if symptoms appear.

Long term medication for 5 special populations

(1) Elderly patients: more prone to adverse reactions, it is recommended to start with lower doses.

(2) Patients with liver injury: Child Pugh grades B/C require a 50% reduction in dosage.

(3) Fertility patients: Strict contraception is required during treatment and for 3 months after discontinuation of medication.