An evaluation of efficiency, safety, tolerability, patient satisfaction, and preference of subcutaneous (SQ) versus intravenous (IV) bortezomib (BTZ) administration in patients with multiple myeloma (MM).

Abstract

e18553 Background: SQ BTZ is approved for use in patients (pts) with MM; however, there is no data assessing the effect of SQ BTZ administration on practice variables (e.g., chair time, total time in clinic) or patient preferences. Furthermore, few studies have evaluated the incidence of PN with SQ BTZ, especially in treatment naïve patients. Methods: This study is divided into three components. Eligible pts for the retrospective efficiency study received ≥ 6 doses of either IV or SQ BTZ in the clinic in 2011 with no concurrent infusions/transfusions other than IV fluids, premedications, or concurrent chemotherapy during their visit. Individual clinic encounters of eligible pts were assessed for chair time and overall clinic visit time, and the average times were compared between the IV and SQ groups. Eligible pts for the preference/satisfaction survey study received ≥ 1 dose of each IV and SQ BTZ in 2011 and spoke English. Percent response to answer choices are reported. De novo SQ BTZ pts who received ≥ 6 doses were eligible for the retrospective safety/tolerability study. Patient chart notes were reviewed to identify the incidence and grade of PN. Results: 92 pts representing 1458 encounters were included in the efficiency study. Average chair time was 54 min less with SQ BTZ than IV BTZ (95% CI, 48 to 59 min; n = 1077 encounters; 89 vs 143 min). Average overall clinic visit time was 46 min less with SQ BTZ than IV BTZ (95% CI, 40 to 52 min; n = 1102 encounters; 123 vs 169 min). 28 of 47 eligible pts completed the survey. 19/28 (67.8%) preferred and 19/28 (67.8%) were more satisfied with SQ BTZ than IV BTZ. 11/28 (39%) experienced an injection site reaction, and 14/28 (50%) agreed they would feel comfortable with self-administration at home. Of the 14 pts receiving SQ BTZ who were BTZ naïve, 11 were newly diagnosed. One of these pts had new PN and 3 had worsened PN from baseline. SQ BTZ was dose reduced in 2 patients and discontinued in 2 pts due to PN. Conclusions: A complete transition in the practice of administration of BTZ from IV to SQ could improve clinic efficiency and provide a more preferable/satisfactory experience for pts.