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Treatment Outcomes and Health Care Resource Utilization in Patients With Newly Diagnosed Multiple Myeloma Receiving Lenalidomide-only Maintenance, Any Maintenance, or No Maintenance: Results from the Connect MM Registry.

Publication ,  Journal Article
Rifkin, RM; Jagannath, S; Durie, BGM; Narang, M; Terebelo, HR; Gasparetto, CJ; Toomey, K; Hardin, JW; Wagner, L; Parikh, K; Abouzaid, S ...
Published in: Clin Ther
July 2018

PURPOSE: Maintenance therapy after autologous stem cell transplantation (ASCT) improves clinical outcomes in multiple myeloma (MM), but the effect of continued treatment with lenalidomide-only maintenance, or any maintenance, on health care resource utilization (HCRU) is largely unknown. METHODS: Here we present an analysis of HCRU and clinical outcomes in a cohort of patients from the Connect MM registry, the largest, ongoing, observational, prospective US registry of patients with symptomatic newly diagnosed MM. In this study, patients with newly diagnosed MM who completed induction and single ASCT without subsequent consolidation received lenalidomide-only maintenance (n = 180), any maintenance (n = 256), or no maintenance (n = 165). HCRU (hospitalization, surgery/procedures, and concurrent medications [growth factors, bisphosphonates, or neuropathic pain medication]) was assessed starting from 100 days post-ASCT for up to 2 years. FINDINGS: Although the rates of hospitalization per 100 person-years were similar across groups at the end of years 1 and 2, the median duration of hospitalization was numerically longer with no maintenance. The rates of use of growth factors, bisphosphonates, and neuropathic pain medication were generally similar in all 3 groups. The receipt of any maintenance was associated with significantly reduced use of neuropathic pain medications during year 1. Of note, lenalidomide-only maintenance was associated with significantly longer progression-free survival (54.5 vs 30.4 months; hazard ratio [HR] = 0.58; 95% CI, 0.43-0.79; P = 0.0005) and overall survival (OS) (median OS not reached in either group; HR = 0.45; 95% CI, 0.28-0.73; P = 0.001) compared with no maintenance. Likewise, the group treated with any maintenance had significantly longer median progression-free survival (44.7 vs 30.4 months; HR = 0.62; 95% CI, 0.47-0.82; P = 0.0008) and OS (median OS not reached in either group; HR = 0.50; 95% CI, 0.33-0.76; P = 0.001) than did the group that did not receive maintenance. IMPLICATIONS: These findings suggest that in this largely community-based study population, post-ASCT maintenance therapy, including lenalidomide-only maintenance, improves clinical outcomes without negatively affecting HCRU. ClinicalTrials.gov identifier: NCT01081028.

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Published In

Clin Ther

DOI

EISSN

1879-114X

Publication Date

July 2018

Volume

40

Issue

7

Start / End Page

1193 / 1202.e1

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Transplantation, Autologous
  • Registries
  • Optoelectronics & Photonics
  • Multiple Myeloma
  • Middle Aged
  • Male
  • Lenalidomide
  • Immunologic Factors
 

Citation

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Rifkin, R. M., Jagannath, S., Durie, B. G. M., Narang, M., Terebelo, H. R., Gasparetto, C. J., … Abonour, R. (2018). Treatment Outcomes and Health Care Resource Utilization in Patients With Newly Diagnosed Multiple Myeloma Receiving Lenalidomide-only Maintenance, Any Maintenance, or No Maintenance: Results from the Connect MM Registry. Clin Ther, 40(7), 1193-1202.e1. https://doi.org/10.1016/j.clinthera.2018.05.017
Rifkin, Robert M., Sundar Jagannath, Brian G. M. Durie, Mohit Narang, Howard R. Terebelo, Cristina J. Gasparetto, Kathleen Toomey, et al. “Treatment Outcomes and Health Care Resource Utilization in Patients With Newly Diagnosed Multiple Myeloma Receiving Lenalidomide-only Maintenance, Any Maintenance, or No Maintenance: Results from the Connect MM Registry.Clin Ther 40, no. 7 (July 2018): 1193-1202.e1. https://doi.org/10.1016/j.clinthera.2018.05.017.
Rifkin RM, Jagannath S, Durie BGM, Narang M, Terebelo HR, Gasparetto CJ, Toomey K, Hardin JW, Wagner L, Parikh K, Abouzaid S, Srinivasan S, Kitali A, Zafar F, Abonour R. Treatment Outcomes and Health Care Resource Utilization in Patients With Newly Diagnosed Multiple Myeloma Receiving Lenalidomide-only Maintenance, Any Maintenance, or No Maintenance: Results from the Connect MM Registry. Clin Ther. 2018 Jul;40(7):1193-1202.e1.
Journal cover image

Published In

Clin Ther

DOI

EISSN

1879-114X

Publication Date

July 2018

Volume

40

Issue

7

Start / End Page

1193 / 1202.e1

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Transplantation, Autologous
  • Registries
  • Optoelectronics & Photonics
  • Multiple Myeloma
  • Middle Aged
  • Male
  • Lenalidomide
  • Immunologic Factors