Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
PLoS One. 2021 May 26;16(5):e0252124. doi: 10.1371/journal.pone.0252124. eCollection 2021.
We aimed to provide real-world information on survival, health care resource utilization (HCRU), and expenditures related to various first lines of therapy (1LOTs) in newly diagnosed multiple myeloma (NDMM) patients who were transplant ineligible (TI).
From the Taiwan National Health Insurance Database (2008-2016), we identified 1,511 NDMM-TI patients who had received 1LOT since June 2012. We categorized 1LOT regimens into four groups: bortezomib (V)+thalidomide (T), V, T, and non-V/T. Patients' characteristics were collected. The overall survival (OS), event-free survival (EFS), frequencies of HCRU (hospitalization, visiting outpatient and emergency departments), and related expenditures within one year after commencement of the 1LOT were evaluated and compared.
The mean age of the included patients was 71.3 (SD 10.7) years, and 40.4% of patients had a CCI score ≥3. Most patients (747; 49.4%) were in the V+T group and, after adjusting for covariates, had a significantly longer OS (median, 22.2 months) and EFS (9.1 months) than those in the T group (12.6 and 4.5 months, respectively) and the non-V/T group (12.2 and 3.2 months, respectively), but they were mostly comparable with patients in the V group (23.8 and 6.6 months, respectively). Compared to those in the V+T group, patients in the T and non-V/T groups had 29% and 39% fewer outpatient visits and 15% and 24% lower total expenditure, respectively.
Our real-world data consolidate evidence for the effectiveness of bortezomib-containing regimens as the 1LOT in NDMM-TI patients at the expense of more outpatient visits and higher total costs.
我们旨在提供关于不适合移植（TI）的新诊断多发性骨髓瘤（NDMM）患者接受一线治疗（1LOT）的生存、医疗资源利用（HCRU）和支出的真实世界信息。
我们从台湾全民健康保险数据库（2008-2016 年）中确定了 1511 名自 2012 年 6 月以来接受过 1LOT 的 NDMM-TI 患者。我们将 1LOT 方案分为四组：硼替佐米（V）+沙利度胺（T）、V、T 和非 V/T。收集患者特征。评估并比较了 1LOT 开始后一年内的总生存率（OS）、无事件生存率（EFS）、HCRU（住院、门诊和急诊就诊）频率以及相关支出。
纳入患者的平均年龄为 71.3（10.7）岁，40.4%的患者 CCI 评分≥3。大多数患者（747 人；49.4%）在 V+T 组中，调整协变量后，OS（中位 22.2 个月）和 EFS（9.1 个月）明显长于 T 组（分别为 12.6 和 4.5 个月）和非 V/T 组（分别为 12.2 和 3.2 个月），但与 V 组患者（分别为 23.8 和 6.6 个月）基本相似。与 V+T 组相比，T 组和非 V/T 组患者的门诊就诊次数分别减少了 29%和 39%，总支出分别降低了 15%和 24%。
我们的真实世界数据证实，硼替佐米联合方案作为 NDMM-TI 患者的一线治疗方案是有效的，但会增加门诊就诊次数和总费用。
