This study evaluated multiple myeloma (MM) treatment patterns in Japan using the Medical Data Vision database. Patients had a new MM diagnosis (2016–2023) and record of MM treatment. Patient characteristics and MM treatments were analyzed descriptively. Time to next treatment (TTNT) was analyzed using Kaplan-Meier methods. The study included 4,505 patients; mean age was 74 years, and 55% were men. The most common 1^st lines of therapy (LOTs) were lenalidomide (Rd; 23%), bortezomib (Vd; 23%), and bortezomib + lenalidomide (VRd; 15%). The 1^st LOT median TTNT was not reached with daratumumab + lenalidomide (DRd), 35.5 months with Rd, and 23.7 months with daratumumab + Vd (DVd). A proteasome inhibitor (PI)–based 1^st LOT was most often followed by an immunomodulatory drug (IMiD)–based 2^nd LOT. Doublet regimens were preferable for patients aged ≥80 years (59% in 1^st LOT). Later LOTs showed broad use of IMiD- and PI-containing regimens. Median TTNT shortened with advancing LOTs, from 25.5 (1^st LOT) to 20.6 (2^nd LOT), 15.5 (3^rd LOT), and 13.0 months (4^th LOT). This study provides an updated view of real-world treatment patterns in patients with MM in Japan, highlighting the need for more effective treatment options particularly for patients receiving later-line therapy.

In newly diagnosed multiple myeloma (NDMM), ixazomib (IXA) maintenance therapy for two years following autologous stem cell transplantation (ASCT) or induction therapy has demonstrated efficacy. However, the efficacy and safety of maintenance therapy beyond two years have not been well studied. We retrospectively analyzed 15 NDMM patients who received IXA maintenance therapy between March 2020 and March 2025. At initiation of maintenance therapy, 14 patients had achieved stringent complete response (sCR) and one had very good partial response (VGPR). Among patients with sCR, 12 achieved minimal residual disease (MRD)-negative status. The median duration of maintenance therapy was 809 days, with nine patients continuing beyond 2 years. Eight of these nine patients maintained sCR. Both hematologic and non-hematologic adverse events occurred but remained manageable with dose modifications and symptomatic treatment. Our findings suggest the feasibility and efficacy of long-term IXA maintenance therapy in multiple myeloma.