POMALIDOMIDE OR CARFILZOMIB USE IN PATIENTS WITH RELAPSED MULTIPLE MYELOMA: REAL-WORLD TREATMENT PATTERNS, TIME TO NEXT TREATMENT, AND ECONOMIC OUTCOMES
(Abstract release date: 05/19/16)
EHA Library. Parikh K. 06/09/16; 133009; E1460
Kejal Parikh
Contributions
Contributions
Abstract
Abstract: E1460
Type: Eposter Presentation
Background
Pomalidomide (POM) is an immunomodulatory agent first approved in the United States in February 2013 in combination with dexamethasone (DEX). Carfilzomib (CAR) is a proteasome inhibitor first approved in the United States in July 2012. Both POM and CAR were approved for patients with relapsed multiple myeloma (MM). Real-world data on the use of these agents in the United States are limited.
Aims
The aim of this study was to fill in gaps in real-world data on treatment patterns and outcomes with POM or CAR in patients with relapsed MM.
Methods
Patients with ≥ 2 MM diagnoses (ICD-9 203.0x) and a POM or CAR claim (index date) from 2/1/2013 to 2/28/2015, assumed to be relapse therapy, were identified in the PharMetrics PlusTM US claims database. Treatment regimens were defined as all MM therapies observed within 60 days of index. Patients with both POM and CAR within 60 days of index were excluded. Time to next treatment (TTNT), a proxy for disease progression, was defined as the addition of a new agent > 60 days from index or treatment restart following a > 90-day gap in therapy. Plan-paid median monthly apportioned costs were reported for total follow-up time, and Wilcoxon rank-sum tests were used to compare the cohorts.
Results
A total of 454 patients indexed to POM (n = 264) or CAR (n = 190) were identified. The mean age was 61.6 years (SD = 9.3 years), 60.1% were men, and these characteristics were similar between groups. Pre-index stem cell transplant occurred at any time in 34.5% of POM patients and 26.3% of CAR patients (P = .064). POM + DEX (47.0%) and POM alone (33.0%) were the most common indexed POM treatments; and CAR alone (45.3%) and CAR + DEX (14.7%) were common indexed CAR treatments. The most frequently observed next-line treatment for POM-indexed patients was addition of or switch to CAR ± DEX (29.0%), and for CAR-indexed patients it was switch to POM + DEX (9.3%), and CAR alone (6.7%) or CAR + DEX + cyclophosphamide (6.7%). For patients followed-up to disease progression (POM, n = 100; CAR, n = 75) the mean TTNT was longer for POM-indexed patients compared with CAR-indexed patients (6.9 vs 5.3 months; P = .0164). With a mean follow-up time of 8.9 months across both groups, 22.0% were still on index treatment, 17.0% were on subsequent treatment (POM, 17.8%; CAR, 15.8%), 9.7% were not on treatment, 25.3% had died (POM, 25.0%; CAR, 25.8%), and 26.0% had lost eligibility prior to classification. Median monthly costs were lower for POM vs CAR patients ($18,298 vs $24,734; P = .001).
Conclusion
This retrospective study of POM or CAR treatment in patients with relapsed MM found a significantly longer TTNT with POM-based regimens vs CAR-based regimens. POM-based regimens were observed to have lower monthly costs through the end of follow-up compared with CAR-based regimens.
Session topic: E-poster
Type: Eposter Presentation
Background
Pomalidomide (POM) is an immunomodulatory agent first approved in the United States in February 2013 in combination with dexamethasone (DEX). Carfilzomib (CAR) is a proteasome inhibitor first approved in the United States in July 2012. Both POM and CAR were approved for patients with relapsed multiple myeloma (MM). Real-world data on the use of these agents in the United States are limited.
Aims
The aim of this study was to fill in gaps in real-world data on treatment patterns and outcomes with POM or CAR in patients with relapsed MM.
Methods
Patients with ≥ 2 MM diagnoses (ICD-9 203.0x) and a POM or CAR claim (index date) from 2/1/2013 to 2/28/2015, assumed to be relapse therapy, were identified in the PharMetrics PlusTM US claims database. Treatment regimens were defined as all MM therapies observed within 60 days of index. Patients with both POM and CAR within 60 days of index were excluded. Time to next treatment (TTNT), a proxy for disease progression, was defined as the addition of a new agent > 60 days from index or treatment restart following a > 90-day gap in therapy. Plan-paid median monthly apportioned costs were reported for total follow-up time, and Wilcoxon rank-sum tests were used to compare the cohorts.
Results
A total of 454 patients indexed to POM (n = 264) or CAR (n = 190) were identified. The mean age was 61.6 years (SD = 9.3 years), 60.1% were men, and these characteristics were similar between groups. Pre-index stem cell transplant occurred at any time in 34.5% of POM patients and 26.3% of CAR patients (P = .064). POM + DEX (47.0%) and POM alone (33.0%) were the most common indexed POM treatments; and CAR alone (45.3%) and CAR + DEX (14.7%) were common indexed CAR treatments. The most frequently observed next-line treatment for POM-indexed patients was addition of or switch to CAR ± DEX (29.0%), and for CAR-indexed patients it was switch to POM + DEX (9.3%), and CAR alone (6.7%) or CAR + DEX + cyclophosphamide (6.7%). For patients followed-up to disease progression (POM, n = 100; CAR, n = 75) the mean TTNT was longer for POM-indexed patients compared with CAR-indexed patients (6.9 vs 5.3 months; P = .0164). With a mean follow-up time of 8.9 months across both groups, 22.0% were still on index treatment, 17.0% were on subsequent treatment (POM, 17.8%; CAR, 15.8%), 9.7% were not on treatment, 25.3% had died (POM, 25.0%; CAR, 25.8%), and 26.0% had lost eligibility prior to classification. Median monthly costs were lower for POM vs CAR patients ($18,298 vs $24,734; P = .001).
Conclusion
This retrospective study of POM or CAR treatment in patients with relapsed MM found a significantly longer TTNT with POM-based regimens vs CAR-based regimens. POM-based regimens were observed to have lower monthly costs through the end of follow-up compared with CAR-based regimens.
Session topic: E-poster
Abstract: E1460
Type: Eposter Presentation
Background
Pomalidomide (POM) is an immunomodulatory agent first approved in the United States in February 2013 in combination with dexamethasone (DEX). Carfilzomib (CAR) is a proteasome inhibitor first approved in the United States in July 2012. Both POM and CAR were approved for patients with relapsed multiple myeloma (MM). Real-world data on the use of these agents in the United States are limited.
Aims
The aim of this study was to fill in gaps in real-world data on treatment patterns and outcomes with POM or CAR in patients with relapsed MM.
Methods
Patients with ≥ 2 MM diagnoses (ICD-9 203.0x) and a POM or CAR claim (index date) from 2/1/2013 to 2/28/2015, assumed to be relapse therapy, were identified in the PharMetrics PlusTM US claims database. Treatment regimens were defined as all MM therapies observed within 60 days of index. Patients with both POM and CAR within 60 days of index were excluded. Time to next treatment (TTNT), a proxy for disease progression, was defined as the addition of a new agent > 60 days from index or treatment restart following a > 90-day gap in therapy. Plan-paid median monthly apportioned costs were reported for total follow-up time, and Wilcoxon rank-sum tests were used to compare the cohorts.
Results
A total of 454 patients indexed to POM (n = 264) or CAR (n = 190) were identified. The mean age was 61.6 years (SD = 9.3 years), 60.1% were men, and these characteristics were similar between groups. Pre-index stem cell transplant occurred at any time in 34.5% of POM patients and 26.3% of CAR patients (P = .064). POM + DEX (47.0%) and POM alone (33.0%) were the most common indexed POM treatments; and CAR alone (45.3%) and CAR + DEX (14.7%) were common indexed CAR treatments. The most frequently observed next-line treatment for POM-indexed patients was addition of or switch to CAR ± DEX (29.0%), and for CAR-indexed patients it was switch to POM + DEX (9.3%), and CAR alone (6.7%) or CAR + DEX + cyclophosphamide (6.7%). For patients followed-up to disease progression (POM, n = 100; CAR, n = 75) the mean TTNT was longer for POM-indexed patients compared with CAR-indexed patients (6.9 vs 5.3 months; P = .0164). With a mean follow-up time of 8.9 months across both groups, 22.0% were still on index treatment, 17.0% were on subsequent treatment (POM, 17.8%; CAR, 15.8%), 9.7% were not on treatment, 25.3% had died (POM, 25.0%; CAR, 25.8%), and 26.0% had lost eligibility prior to classification. Median monthly costs were lower for POM vs CAR patients ($18,298 vs $24,734; P = .001).
Conclusion
This retrospective study of POM or CAR treatment in patients with relapsed MM found a significantly longer TTNT with POM-based regimens vs CAR-based regimens. POM-based regimens were observed to have lower monthly costs through the end of follow-up compared with CAR-based regimens.
Session topic: E-poster
Type: Eposter Presentation
Background
Pomalidomide (POM) is an immunomodulatory agent first approved in the United States in February 2013 in combination with dexamethasone (DEX). Carfilzomib (CAR) is a proteasome inhibitor first approved in the United States in July 2012. Both POM and CAR were approved for patients with relapsed multiple myeloma (MM). Real-world data on the use of these agents in the United States are limited.
Aims
The aim of this study was to fill in gaps in real-world data on treatment patterns and outcomes with POM or CAR in patients with relapsed MM.
Methods
Patients with ≥ 2 MM diagnoses (ICD-9 203.0x) and a POM or CAR claim (index date) from 2/1/2013 to 2/28/2015, assumed to be relapse therapy, were identified in the PharMetrics PlusTM US claims database. Treatment regimens were defined as all MM therapies observed within 60 days of index. Patients with both POM and CAR within 60 days of index were excluded. Time to next treatment (TTNT), a proxy for disease progression, was defined as the addition of a new agent > 60 days from index or treatment restart following a > 90-day gap in therapy. Plan-paid median monthly apportioned costs were reported for total follow-up time, and Wilcoxon rank-sum tests were used to compare the cohorts.
Results
A total of 454 patients indexed to POM (n = 264) or CAR (n = 190) were identified. The mean age was 61.6 years (SD = 9.3 years), 60.1% were men, and these characteristics were similar between groups. Pre-index stem cell transplant occurred at any time in 34.5% of POM patients and 26.3% of CAR patients (P = .064). POM + DEX (47.0%) and POM alone (33.0%) were the most common indexed POM treatments; and CAR alone (45.3%) and CAR + DEX (14.7%) were common indexed CAR treatments. The most frequently observed next-line treatment for POM-indexed patients was addition of or switch to CAR ± DEX (29.0%), and for CAR-indexed patients it was switch to POM + DEX (9.3%), and CAR alone (6.7%) or CAR + DEX + cyclophosphamide (6.7%). For patients followed-up to disease progression (POM, n = 100; CAR, n = 75) the mean TTNT was longer for POM-indexed patients compared with CAR-indexed patients (6.9 vs 5.3 months; P = .0164). With a mean follow-up time of 8.9 months across both groups, 22.0% were still on index treatment, 17.0% were on subsequent treatment (POM, 17.8%; CAR, 15.8%), 9.7% were not on treatment, 25.3% had died (POM, 25.0%; CAR, 25.8%), and 26.0% had lost eligibility prior to classification. Median monthly costs were lower for POM vs CAR patients ($18,298 vs $24,734; P = .001).
Conclusion
This retrospective study of POM or CAR treatment in patients with relapsed MM found a significantly longer TTNT with POM-based regimens vs CAR-based regimens. POM-based regimens were observed to have lower monthly costs through the end of follow-up compared with CAR-based regimens.
Session topic: E-poster
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