Rosenberg Tine, Kirkegaard Jannie, Gundesen Michael Tveden, Rasmussen Maja Kjær, Dieperink Karin Brochstedt, Lund Thomas
Department of Haematology, Odense University Hospital, Odense, Denmark.
Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Eur J Haematol. 2025 Jul;115(1):72-81. doi: 10.1111/ejh.14409. Epub 2025 Mar 31.
Multiple myeloma is an incurable cancer with lifelong treatment needs. This, together with a global nursing shortage, calls for new approaches for future treatment. In this study, we therefore investigated the feasibility of home-based subcutaneous daratumumab administered by primary care nurses outside the hospital.
Applying a mixed-methods prospective design, we included 30 patients; 18 had completed ≥ 6 cycles of daratumumab treatment, and 12 were newly started. New patients were followed for six 28-day cycles, with every second treatment administered outside the hospital. Patients already on treatment were followed for seven cycles with 2/3 treatments administered outside the hospital.
Of 123 administrations planned at the hospital, 122 (97.6%) were administered and three were cancelled. Of 144 administrations planned outside the hospital, 133 (92.4%) were administered, six were redirected to the hospital, and five were cancelled. No significant difference between numbers of cancellations/redirections was observed. Patients spent significantly longer time on treatment at the hospital, even when deducting travel time. Reducing patients' visits to the hospital did not cause additional unplanned contacts with the healthcare system.
This study thus concludes that administration of daratumumab outside the hospital is safe, feasible, and time saving.
ClinicalTrials.gov ID: NCT05306587.
多发性骨髓瘤是一种无法治愈的癌症，需要终身治疗。这与全球护理人员短缺的情况共同促使我们寻求未来治疗的新方法。因此，在本研究中，我们调查了由基层医疗护士在院外进行居家皮下注射达雷妥尤单抗的可行性。
采用混合方法前瞻性设计，我们纳入了30例患者；其中18例已完成≥6个周期的达雷妥尤单抗治疗，12例为新开始治疗的患者。新患者接受六个28天周期的随访，每隔一次治疗在院外进行。已接受治疗的患者接受七个周期的随访，其中2/3的治疗在院外进行。
计划在医院进行的123次给药中，122次（97.6%）实际给药，3次取消。计划在院外进行的144次给药中，133次（92.4%）实际给药，6次改至医院进行，5次取消。取消/改至医院的次数之间未观察到显著差异。即使扣除出行时间，患者在医院接受治疗的时间仍显著更长。减少患者到医院就诊并未导致与医疗系统的额外非计划接触。
因此，本研究得出结论，在院外给予达雷妥尤单抗是安全、可行且节省时间的。
ClinicalTrials.gov标识符：NCT05306587。
