The impact Cold Agglutinin Disease (CAD) can have on patients’ lives

Currently, there are no FDA-approved treatments for CAD1

Because there are no approved treatments for CAD, patients currently rely on the following alternative approaches2:

Icon representing cold avoidance which is one nonspecific treatment approach to CAD

Cold
avoidance*

Icon representing crisis intervention for patients with severe anemia

Crisis
intervention

Icon representing pharmacotherapy

Pharmacotherapy

*Avoid triggering temperatures to relieve symptoms.

Transfusions and/or plasmapheresis, which are often required to stabilize patients with severe anemia.

Pharmacotherapy has been used off label with evidence of efficacy from earlier phase clinical trials.


Despite attempts to manage CAD with alternative therapy, many patients remain in a hemolytic state over 5 years3

LDH

Chart depicting LDH levels were elevated consistently over 5 years even with nonspecific approaches

Bilirubin

Chart depicting bilirubin levels were elevated consistently over 5 years even with nonspecific approaches

Hemoglobin

Chart depicting hemoglobin levels were elevated consistently over 5 years even with nonspecific approaches

Data from a population-based retrospective follow-up study of patients with CAD (n=86).


CAD can have severe consequences

72% of patients

had at least 1 severe anemia event within the first year of follow-up1

Data from a retrospective review of a healthcare system database in patients with CAD (n=29) who were included based on hemoglobin readings and follow-up.

67% of patients

had a severe anemia event within the first 6 months of nonspecific therapy1

Data collected from 18 patients with at least 6 months of follow-up after initial therapy in retrospective review of healthcare database.


The burden of hospitalization and transfusion is consistent in CAD, regardless of season4

Four icons of weather representing all seasons
Healthcare resource utilization, including hospital and transfusion days, remained similar between winter and summer months§

Data from a retrospective review of a claims database (n=808).

§The median minimum Hb value for winter compared with summer was decreased by 0.54 g/dL (P<0.001). The median maximum bilirubin and LDH increased by 0.12 mg/dL (P=0.005) and 42.1 U/L (P<0.001) in winter vs summer, respectively.


Hear from Brad,

a patient living with CAD, as he discusses its impact on his life.

When they said I was primary CAD, cold agglutinin, my first reaction is, “Okay, what is it?” and second reaction is “Well, let’s fix it,” and unfortunately the doctors all say exactly the same thing, “There’s nothing we can do for you, there’s no cure for it,” and it’s very cavalier the way they say, “Don’t get cold.” “Don’t get cold” is a very easy thing for people to say, and it’s easy for people to deal with, but when you have this disease it’s not so easy to deal with because cold can happen at any point in time. Coming out of the shower, just that temperature change from your body being wet to a cooler environment can trigger problems, right? Going in a heated swimming pool, the heated swimming pool is fine, that’s something you can deal with. It’s coming out of the swimming pool that is where the change, that temperature change, and it is that minor of a change, right? There’s a lot of precautions that we now have to take in our lives, which changed our lives. It changes all the time, right? That’s the whole thing with it is we may be used to something this year, next year there’s probably going to be something different. This is a journey that is uncertain and is always uncertain, and it never, it never really nails itself down because it changes all the time, right? So psychologically, you have high days and you have low days, and absolutely I went through depression and anger and the whole gamut of emotions for it. Now I’ve gotten to the point and I’m at a good point in my life where I’ve accepted it now, and now it’s just my day-to-day changes and it’s just you adapt to that, but psychologically it’s hard to deal with because most people will look at you and say, “Well, you look fine. You look fine,” and when people say that, it’s “Well, yeah, I look fine but inside I’m not; it’s the inside part that is not working properly.” And that’s part of the battle, too, is because everybody that you meet says, “Well, you don’t look sick.” Well, I don’t look sick because I try and keep myself healthy and all the rest, right? But yeah, it’s a hard journey and I’m not going to deny that it’s not but, like I said, to me, this is probably one of the hardest things I’ve ever done in my life–is to deal with this day-to-day.


Icon of vein representing CAD risk

CAD can have
serious consequences

Icon of checklist

Understand criteria
to diagnose CAD
in patients

CAD=Cold Agglutinin Disease; Hb=hemoglobin; LDH=lactate dehydrogenase.
References: 1. Mullins M, Jiang X, Bylsma LC, et al. Cold agglutinin disease burden: a longitudinal analysis of anemia, medications, transfusions, and health care utilization. Blood Adv. 2017;1(13):839-848. 2. Berentsen S, Tjønnfjord GE. Diagnosis and treatment of cold agglutinin mediated autoimmune hemolytic anemia. Blood Rev. 2012;26(3):107-115. 3. Berentsen S, Ulvestad E, Langholm R, et al. Primary chronic cold agglutinin disease: a population based clinical study of 86 patients. Haematologica. 2006;91(4):460-466. 4. Röth A, Fryzek J, Jiang X, Morales J, Broome CM. Seasonal patterns of anemia, hemolytic marker and healthcare resource utilization among patients with cold agglutinin disease in the United States: a retrospective analysis. Blood. 2018;132(suppl 1):4873. doi:10.1182/blood-2018-99-116893