Burden Of Multiple Myeloma Research Articles

Measurement of the major ignored burden of multiple myeloma, pernicious anaemia and of other haematological conditions on partners and family members: A cross-sectional study.

Having a haematological condition can adversely affect the quality of life (QoL) of family members/partners of patients. It is important to measure this often ignored burden in order to implement appropriate supportive interventions. To measure current impact of haematological conditions on the QoL of family members/partners of patients, using the Family Reported Outcome Measure-16 (FROM-16). A cross-sectional study, recruited online through patient support groups, involved UK family members/partners of people with haematological conditions completing the FROM-16. 183 family members/partners (mean age = 60.5 years, SD = 13.2; females = 62.8%) of patients (mean age = 64.1, SD = 12.8; females = 46.4%) with 12 haematological conditions completed the FROM-16. The FROM-16 mean total score was 14.0 (SD = 7.2), meaning 'a moderate effect on QoL'. The mean FROM-16 scores of family members of people with multiple myeloma (mean = 15.8, SD = 6.3, n = 99) and other haematological malignancies (mean = 13.9, SD = 7.8, n = 29) were higher than of people with pernicious anaemia (mean = 10.7, SD = 7.5, n = 47) and other non-malignant conditions (mean = 11, SD = 7.4, n = 56, p < .01). Over one third (36.1%, n = 183) of family members experienced a 'very large effect' (FROM-16 score>16) on their quality of life. Haematological conditions, in particular those of malignant type, impact the QoL of family members/partners of patients. Healthcare professionals can now, using FROM-16, identify those most affected and should consider how to provide appropriate holistic support within routine practice.

Burden of multiple myeloma in China: an analysis of the Global Burden of Disease, Injuries, and Risk Factors Study 2019.

There is limited data to comprehensively evaluate the epidemiological characteristics of multiple myeloma (MM) in China; therefore, this study determined the characteristics of the disease burden of MM at national and provincial levels in China. The burden of MM, including incidence, mortality, prevalence, and disability-adjusted life years (DALYs), with a 95% uncertainty interval (UI), was determined in China following the general analytical strategy used in the Global Burden of Disease, Injuries, and Risk Factors Study 2019. The trends in the burden of MM from 1990 to 2019 were also evaluated. There were an estimated 347.45 thousand DALYs with an age-standardized DALY rate of 17.05 (95% UI, 12.31-20.77) per 100,000 in 2019. The estimated number of incident case and deaths of MM were 18,793 and 13,421, with age-standardized incidence and mortality rates of 0.93 (95% UI, 0.67-1.15) and 0.67 (95% UI, 0.50-0.82) per 100,000, respectively. The age-specific DALY rates per 100,000 increased to more than 10.00 in the 40 to 44 years age group reaching a peak (93.82) in the 70 to 74 years age group. Males had a higher burden than females, with approximately 1.5- to 2.0-fold sex difference in age-specific DALY rates in all age groups. From 1990 to 2019, the DALYs of MM increased 134%, from 148,479 in 1990 to 347,453 in 2019. The burden of MM has doubled over the last three decades, which highlights the need to establish effective disease prevention and control strategies at both the national and provincial levels.

The burden of multiple myeloma in Mexico: an epidemiologic investigation of the national health system

The burden of multiple myeloma in Mexico: an epidemiologic investigation of the national health system

Secular Trends in the Burden of Multiple Myeloma From 1990 to 2019 and Its Projection Until 2044 in China.

ObjectiveMultiple myeloma (MM) imposes a heavy burden in China. Understanding the secular trend of MM burden and projecting its future trend could facilitate appropriate public health planning and improve the management of MM.MethodsSex-specific incidence and mortality rates of MM in China from 1990 to 2019 were collected from the Global Burden of Disease 2019 study. The secular trend of MM burden was analyzed by joinpoint regression. Age–period–cohort model was used to analyze the effects of age, period, and birth cohort on MM burden and project future trends up to 2044.ResultsFrom 1990 to 2019, the age-standardized incidence and mortality rates of MM continued to increase in males. For females, the age-standardized rates were stable in MM incidence and decreased in MM mortality. Males had a higher disease burden of MM than females. Age effects were the most significant risk factor for MM incidence and mortality. Moreover, the risk of MM incidence and mortality increased with increasing time period but decreased with birth cohort in males and females. The age-standardized incidence and mortality rates of MM in China is predicted to be continuously increasing over the next 25 years.ConclusionThe burden of MM in China is expected to continue to increase in the future, with significant sex difference. A comprehensive understanding of the risk characteristics and disease pattern of MM could help develop timely intervention measures to effectively reduce its burden.

PCR30 Health-Related Quality of Life (HRQOL) of Patients with Transplant-Ineligible Newly Diagnosed Multiple Myeloma (TIE NDMM) and Relapsed/Refractory Multiple Myeloma (RRMM) in Phase III Randomized Controlled Trials (RCTS): A Targeted Literature Review

The burden of multiple myeloma on patients’ HRQoL is significant and PROs should be considered for evaluating treatment patterns. This targeted review studies HRQoL in patients with TIE NDMM and RRMM receiving daratumumab combination regimens.

Real-world healthcare resource utilization and costs among patients with multiple myeloma in the United States.

e18811 Background: The economic burden of multiple myeloma (MM) has been shown to increase with more advanced lines of therapy (LOTs). Given the rapidly evolving treatment landscape of MM, this study aimed to describe the current real-world healthcare resource use (HRU) and costs among patients with MM across LOTs. Methods: A commercial insurance claims database was used to identify patients with ≥2 MM diagnoses who initiated a LOT containing an antineoplastic agent for MM between 1/2016 and 2/2021, had continuous insurance coverage ≥6 months before and ≥60 days after first line (1L) initiation, and never received stem cell transplant. LOTs were defined based on agents used within a 60-day period. End of LOT was defined when patients switched treatment, or after a treatment gap of 90 days. HRU and costs (in 2021 USD) were reported for the duration of each LOT (from initiation of LOT to initiation of a subsequent LOT or end of coverage). Results: 1492 patients initiated 1L, 681 initiated 2L, 359 initiated 3L and 188 initiated 4L. Mean age at 1L initiation was 66.6 years. Mean duration of LOT (10.7, 9.4, 8.1 and 10.2 months in 1L, 2L, 3L and 4L, respectively) was longer in 1L than in subsequent LOTs. All-cause monthly outpatient (OP) and inpatient (IP) visits were stable across LOTs (5.0-5.6 OP visits; 0.21-0.32 IP visits). However, mean monthly all-cause costs were lowest in 1L (15.9% - 34.9% lower) as compared to subsequent LOTs ($23.6K in 1L, $29.7K in 2L, $27.3K in 3L and $31.8K in 4L; Table). Conclusions: In this study, the duration of LOT was the longest among 1L patients. Total all-cause healthcare costs were the lowest in 1L than in more advanced LOTs. This suggests that selection of 1L best treatment regimen upfront that prolongs time to disease progression could reduce the overall economic burden of MM.[Table: see text]

Towards a unified approach for multiple myeloma care in Kenya - proceedings of the Inaugural Multiple Myeloma Congress

The rising burden of multiple myeloma in Kenya has not been met by a commensurate effort for control. Patients and practitioners struggle with unavailability and unaffordability of diagnostics, drugs and stem cell transplant leading to presentation at advanced stages and under-treatment with increased morbidities and mortality. A concerted effort among stakeholders is urgently needed to develop strategies for myeloma control. The scarcity of providers also carries grave consequences for Kenyan patients. The Academic Model Providing Access To Healthcare (AMPATH) multiple myeloma program organized the Inaugural Virtual Multiple Myeloma Congress to achieve both interactive specialist instruction and stakeholder engagement. Expert presenters and panellists from diverse disciplines were invited to offer in-depth presentations on myeloma care and case studies from panellists´ practice were used to contextualize learning points and form a basis for generating debate on the challenges facing providers and opportunities for care improvement. An audience of health professionals offering care to myeloma patients was invited. The underlying principle of recommendations developed during the congress was collaboration among in-country and international practitioners, researchers and policy experts from private and public sector. This partnership of stakeholders bears the potential of pooling scarce resources and for collective advocacy towards better patient care

Incidence and mortality of multiple myeloma in China, 2006\u20132016: an analysis of the Global Burden of Disease Study 2016

BackgroundThe accurate information about burden of multiple myeloma (MM) at national and provincial level remains unknown in China.MethodsFollowing the general analytical strategy used in GBD 2016, the age-, sex-, and province-specific incidence and mortality in China were analyzed. Trends in the incidence and mortality from 2006 to 2016 were evaluated.ResultsIt was estimated that there were 16,500 new cases and 10,300 deaths of multiple myeloma in China in 2016. The age-standardized incidence rates (ASIR) and mortality rates (ASMR) per 100,000 population were 1.03 (95% UI, 0.88–1.17) and 0.67 (95% UI, 0.59–0.77) in 2016. Males had higher incidence and mortality rates than females in all age groups. An upward trend with age in incidence and mortality was observed. Higher incidence and mortality rates clustered in the developed provinces. The incidence of MM in China increased significantly from 2006 to 2016, while the mortality increased from 2006 to 2014, and remained stable from 2014 to 2016.ConclusionThe burden of MM showed a heterogeneous pattern in China, which highlighted the need of tailored disease prevention and control strategies in both national and provincial levels.

Incidence and Mortality of Multiple Myeloma in China, 2006-2016: An Analysis of the Global Burden of Disease Study 2016

Background: The accurate information about burden of multiple myeloma (MM) at national and provincial level remain unknown in China. Methods: We used data from the Global Burden of Disease Study 2016 (GBD 2016) to calculate the burden of MM and to describe the temporal trend in China. Findings: It was estimated that there were 16 500 new cases and 10 300 deaths of multiple myeloma in China. The age-standardized incidence rates (ASIR) and mortality rates (ASMR) per 100 000 population were 1.03 (95%UI, 0.88-1.17) and 0.67 (95%UI, 0.59-0.77). Males had higher incidence and mortality rates than females in all age groups. An upward trend with age in incidence and mortality were observed. Furthermore, higher incidence and mortality rates clustered in those developed provinces. The incidence of MM in China increased significantly from 2006 to 2016, while the mortality increased from 2006 to 2014, and then remained stable from 2014 to 2016. Interpretation: The burden of MM had a heterogeneous pattern in China, which highlighted the need of differentiated disease prevention and control strategies in both national and provincial levels. Funding Statement: China Special Program for Basic Research 2014 from Ministry of Science and Technology (Grant number: 2014FY121100). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: Not required.

The impact of newly approved drugs on clinical and operational strategies for multiple myeloma clinical trials.

e19511 Background: The global burden of multiple myeloma (MM) has increased steadily in last 3 decades. The IARC reports there were ~160,000 new cases worldwide in 2018. There has been an increase in the development and approval of more effective targeted therapy options (new immunomodulatory agents, proteasome inhibitors, and monoclonal antibodies); this, coupled with high adoption of these therapies presents a major challenge in enrollment of current ongoing clinical trials. We assessed the impact of near-term regulatory approvals on clinical trial enrollment. Methods: Public domain clinical trial enrollment data from MM studies (Phase I, I/II, II) closed/completed between 2011-2018 were used to determine enrollment trends pre and post 2014. We leveraged real-world medical claims data to project/model adoption of recently approved drugs in the U.S.; additionally, drug sales volume data was used to evaluate ex-US national adoption trends. The utilization rates of 5 recently approved drugs by regimen and line of treatment was determined. Results: In the U.S., there is a 13% increase in median enrollment duration with a corresponding 25% decrease in median p/s/m enrollment in MM studies, irrespective of phase, where enrollment was completed between 2015 -2018 compared to 2011-2014. We hypothesize that one of the factors for this increase in enrollment timeline is the approval and adoption of newly approved therapies post 2014. Two of the five recently approved drugs show a steady increase in the number of patients treated over 2016, 2017 and 2018, while one of the drugs plateaus over the same period. Outside of the U.S., our analysis confirms the existence of gaps in time to approval /adoption of recently approved drugs; for example, we observe a two-year delay in approval/adoption for one of the drugs in France compared to the other countries in Western Europe. Conclusions: There are over 10 investigational MM drugs currently in development which are anticipated to be granted approval between 2019-2021. Factoring the real-world adoption of near-term drug approval into global clinical and operational strategies offers insights into mitigating potential future enrollment challenges.

Venous Thromboembolism in Hospitalized Patients with Multiple Myeloma: A Nationwide Analysis

Background: The burden of multiple myeloma has increased in last 30 years, both in US and globally. Patients with multiple myeloma are at increased risk of developing venous thromboembolism (VTE) resulting in significant morbidity and mortality. This study aimed to (1) determine patient and hospital characteristics associated with VTE, (2) assess the impact of VTE on in-hospital mortality and prolonged hospitalization, and (3) examine trends in the rates of VTE and VTE-associated in-hospital mortality and prolonged hospitalization in patients with multiple myeloma.Methods: A retrospective analysis of Nationwide Inpatient Sample, 2008 - 2014, was conducted. International Classification of Diseases-9-Clinical Modification codes were used to identify hospitalized patients (aged ≥ 18 years) with multiple myeloma. Trends in the prevalence of VTE and VTE-associated in-hospital mortality and prolonged hospitalization rates were assessed using the Cochrane-Armitage test. Weighted, multilevel hierarchical logistic regression using generalized linear mixed models with generalized estimated equations were used to examine the association between patient and hospital characteristics and study outcomesResults: Among 136,652 hospitalized patients with multiple myeloma, 4.2% were diagnosed with VTE. Although statistically insignificant, a slight increase in VTE rates were observed from 2008 to 2014 (3.9% to 4.4%) (p 0.18). In adjusted multilevel hierarchical regression, we found higher odds of VTE in male gender (odds ratio [OR] = 1.08, 95% Confidence Interval [CI] = 1.02 - 1.14), Black race (OR = 1.11, 95% CI = 1.03 - 1.19), those who had a major surgery (OR = 1.73, 95% CI = 1.62 - 1.85), and higher Elixhauser comorbidity index (OR = 3.73, 95% CI = 2.66 - 5.23). Hospital level correlates of VTE included: admission to teaching vs. non-teaching (OR = 1.07, 95% CI = 1.01 - 1.13), and admission to medium vs. small sized hospitals (OR = 1.11, 95% CI = 1.01 - 1.23), while lower odds of VTE were noted among patients admitted to hospitals located in Northeast (OR = 0.91, 95% CI = 0.84 - 0.98) vs. South. Patients diagnosed with vs. without VTE had higher odds of in-hospital mortality (OR = 1.36, 95% CI = 1.22 - 1.51) and prolonged hospital stay (OR = 1.65, 95% CI = 1.55 - 1.75). A statistically significant trend for decreasing VTE associated mortality (10.0% to 5.3%) (p <.001) and prolonged hospitalization (32.1% to 28.2%) (p <.001) rates were observed across study years.Conclusions: During the study period, there has been an increase in rate of VTE among patients with multiple myeloma. Patients with multiple myeloma and VTE had a high risk of in-hospital mortality compared to those without VTE; however, rates of VTE-associated in-hospital mortality and prolongation of hospitalization have decreased over time. Hospital level characteristics were significantly associated with VTE. These findings might reflect changing detection guidelines and better management of VTE in cancer patients. Lastly, patient level characteristics independently predict the occurrence of VTE. Given the higher in-hospital mortality associated with patients with VTE and multiple myeloma, there is a need for prospective studies to identify effective strategies to prevent VTE in this patient population and improve outcomes. [Display omitted] DisclosuresSanfilippo:Bristol-Myers Squibb: Speakers Bureau.

Decreasing M Spike With Increasing Tumor Burden in Multiple Myeloma-Reply

—At the time the patient was initially seen in 1978, the differential diagnosis of Dr Bouvet's patient's condition should have included solitary secretory myeloma and benign monoclonal gammopathy. In 1980, the patient had had moderate bone pains. At that time, she probably had multiple myeloma with relatively low tumor burden. In January 1981, the patient had clear-cut roentgenographic and bone marrow evidence of multiple myeloma. It would have been important to have verified the absence of myeloma proteins in her urine at that time. The salient feature of this patient's condition was the continued presence of two M spikes belonging to the same immunoglobulin subclass throughout the clinical course and a decrease in only one of the two M spikes in face of clinical and laboratory evidence of large tumor burden of multiple myeloma in January 1981. In this case, the decrease in one of the two M spikes was