2024 年 14 巻 5 号 p. 27-41
Objective: This retrospective observational cohort study described real-world drug utilisation patterns in multiple myeloma (MM) using Japan’s Medical Data Vision (MDV) database.
Methods: Patients aged ≥18 were indexed on their first claim for a confirmed MM diagnosis. Adapting a published algorithm, lines of treatment (LOTX, where X = line number) were identified for each patient, and regimen combinations summarised by drug name/class.
Results: Of 13,073 patients included, this publication focuses on 9,679 diagnosed with MM in 2016 or later, after newer MM agents were available in Japan. Of these, 48.9% had no MM drug claims during follow-up; 5.8% received stem cell transplants. Besides steroids, proteasome inhibitors (particularly bortezomib) were most common in LOT1 (65.8%); from LOT2 onwards, immunomodulatory imide drugs (e.g. lenalidomide) were most common. Across 2016–2020, the most common LOT1 regimens were bortezomib-dexamethasone (25.9%), followed by lenalidomide-bortezomib-dexamethasone (17.0%) and lenalidomide-dexamethasone (16.2%); the most common LOT2 regimen was lenalidomide-dexamethasone (17.4%), followed by lenalidomide-bortezomib-dexamethasone (8.2%). Over the years, use of bortezomib-melphalan-prednisone and melphalan-prednisone in LOT1 decreased, while lenalidomide-dexamethasone and lenalidomide-bortezomib-dexamethasone increased.
Conclusions: MM treatment patterns continue to evolve alongside increasing availability of novel therapies in Japan. While proteasome inhibitors have remained the backbone of MM treatment, monoclonal antibodies have become more common.
Mini-abstract: Multiple myeloma treatment patterns are evolving alongside the approval and uptake of novel therapies in Japan; monoclonal antibodies have become more common, with proteasome inhibitors remaining a backbone of treatment.
