Tisch Cancer institute at Mount Sinai Medical Center, New York, NY, USA.
IQVIA, Falls Church, VA, USA.
J Oncol Pharm Pract. 2022 Mar;28(2):395-409. doi: 10.1177/1078155221995532. Epub 2021 Feb 20.
Real-world evidence on later line treatment of relapsed/refractory multiple myeloma (RRMM) is sparse. We evaluated clinical outcomes among RRMM patients in the 1-year following treatment with pomalidomide or daratumumab and compared economic outcomes between RRMM patients and non-MM patients.
Adult patients with ≥1 claim of pomalidomide or daratumumab were identified between January 2012 and February 2018 using IQVIA PharMetrics® Plus US claims database. Patients were required to have a diagnosis or treatment for MM and a claim of any immunomodulatory drugs and proteasome inhibitors before the index date. Mean time to new therapy, overall survival (OS) using Kaplan-Meier curve and adverse events (AEs) were reported over the 1-year post-index period. RRMM patients were also matched to a non-MM comparator cohort and economic outcomes were compared between the two cohorts.
289 RRMM patients were matched to 1,445 patients without MM. Most prevalent hematological AE was anemia (72.0%) and non-hematological AE was infections (75.4%). Mean (SD) time to a new treatment was 4.7 (5.3) months and median OS was 14.6 months. RRMM patients had significantly higher hospitalizations and physician office visits (Both < .0001) compared to non-MM patients. Adjusting for baseline characteristics, patients with RRMM had 4.9 times (95% CI 3.8-6.4, < .0001) the total healthcare costs compared with patients without MM. The major driver of total costs among RRMM patients was pharmacy costs (67.3%).
RRMM patients showed a high frequency of AEs, low OS, and a substantial economic burden suggesting need for effective treatment options.
关于复发/难治性多发性骨髓瘤（RRMM）后续治疗的真实世界证据很少。我们评估了接受泊马度胺或达雷妥尤单抗治疗后 1 年内 RRMM 患者的临床结局，并比较了 RRMM 患者和非-MM 患者的经济结局。
使用 IQVIA PharMetrics® Plus US 索赔数据库，从 2012 年 1 月至 2018 年 2 月期间确定了≥1 次泊马度胺或达雷妥尤单抗用药的成年患者。患者在索引日期前必须有 MM 的诊断或治疗以及免疫调节剂和蛋白酶体抑制剂的用药记录。报告了索引日期后 1 年内的新治疗方法中位时间、总生存期（OS）采用 Kaplan-Meier 曲线和不良事件（AE）。RRMM 患者还与非-MM 对照组进行了匹配，并比较了两组之间的经济结局。
289 例 RRMM 患者与 1445 例非 MM 患者相匹配。最常见的血液学 AE 是贫血（72.0%），非血液学 AE 是感染（75.4%）。新治疗方法的中位时间为 4.7（5.3）个月，中位 OS 为 14.6 个月。与非-MM 患者相比，RRMM 患者的住院和医生就诊次数明显更高（均<0.0001）。调整基线特征后，RRMM 患者的总医疗保健费用是无 MM 患者的 4.9 倍（95%CI 3.8-6.4，<0.0001）。RRMM 患者总费用的主要驱动因素是药物治疗费用（67.3%）。
RRMM 患者表现出 AE 发生率高、OS 低且经济负担重，这表明需要有效的治疗选择。
