PPI co-medication linked to earlier treatment switching in dasatinib-treated CML patients

Dasatinib absorption depends on gastric pH, and proton pump inhibitors (PPIs) are known to reduce dasatinib exposure. But does this interaction matter in routine care?

In a new study published in Annals of Hematology, Sabrina Mueller, Chen-Chia Pan, Prof. Dr. Thomas Wilke and co-authors analysed German statutory health insurance claims data from 2010 to 2024. Adults with chronic myeloid leukemia (CML) who started dasatinib were compared with and without concomitant PPI use, using propensity score matching and Cox regression.

Key findings

• Around one in five dasatinib patients also received a PPI.

• PPI co-medication was associated with earlier switching to another CML therapy (prevalent cohort: HR 1.87; 95% CI 1.18-2.95; p = 0.008).

• The association was directionally consistent in the incident cohort and in all sensitivity analyses.

While causality cannot be established, the results are consistent with the known pH-dependent interaction and support existing recommendations to avoid PPI co-medication during dasatinib therapy whenever feasible.

Mueller S, Pan C-C, Bosák J, Hofmann J, Losch FO, Wilke T, Deiters B, Žáčková D. Annals of Hematology (2026) 105:351. Read the full article: https://doi.org/10.1007/s00277-026-07211-w