Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 6;18(4):e0283931.
doi: 10.1371/journal.pone.0283931. eCollection 2023.

Treatment pattern and clinical outcomes in multiple myeloma patients in Japan using the Medical Data Vision claims database

Hiroshi Handa  1 , Tadao Ishida  2 , Shuji Ozaki  3 , Asuka Mori  4 , Kenichi Kato  5 , Shinsuke Iida  6
Affiliations

Treatment pattern and clinical outcomes in multiple myeloma patients in Japan using the Medical Data Vision claims database

Hiroshi Handa et al. PLoS One. .

Abstract

Multiple myeloma therapy has made remarkable progress with the advent of new drugs. We explored the treatment pattern and outcomes in Japanese patients with multiple myeloma using the Medical Data Vision database. Patients were categorized as per the initial diagnosis period (2003-2015 and 2016-2020), considering the adoption of these new agents and then based on stem cell transplantation. Overall, 6438 patient data were extracted as eligible for data analysis, and the median age at the index diagnosis date was 72.0 years. Bortezomib/dexamethasone was the most common regimen for induction therapy in patients requiring stem cell transplantation from 2003-2015, and the use of bortezomib/lenalidomide/dexamethasone increased from 2016-2020. Lenalidomide/dexamethasone was the most commonly used post-transplant therapy. In the non-stem cell transplantation group, bortezomib/dexamethasone was mainly used for both periods, while lenalidomide/dexamethasone was primarily used from 2016-2020. There was a trend toward shorter first-line treatment duration and a shift to additional treatment patterns with new drugs at the following lines. The time to inpatient death period suggested an improvement between the two periods. Thus, this study revealed that recent diversification of treatment options is preferred and contributes to improved outcomes in the clinical practice of multiple myeloma in Japan.

PubMed Disclaimer

Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests. HH received consulting fees and honoraria from Janssen, Ono, and Takeda; grants from Takeda, Kyowa Kirin, and BMS. TI received consulting fees and honoraria from Ono, Takeda, BMS, Janssen, and Sanofi; research fundings support from Takeda, Janssen, Pfizer, and BMS. SO has nothing to declare. AM is an employee of Janssen Pharmaceutical K.K. KK was an employee of Janssen Pharmaceutical K.K and is currently affiliated with Kite Japan Gilead Sciences, Tokyo, Japan, and have share in Gilead Science. SI is the current editor in Cancer Science journal and received consulting fees and honoraria from BMS, Janssen, Takeda, Ono, Sanofi, and Pfizer; research funding support from BMS, Janssen, Daiichi Sankyo, Amgen, Ono, AbbVie GK, GSK, Eli Lilly, Caelum Biosciences, Inc., Pfizer, Takeda, and Sanofi; grants from Chugai, Takeda, Ono, and Sanofi.

Figures

Fig 1
Fig 1. Study population flowchart.
MDV, Medical Data Vision; SCT, stem cell transplantation. Note: ICD10 codes I12.0, I13.1, N03.2 -N03.7, N05.2 -N05.7, N18.x, N19.x, N25.0, Z49.0-Z49.2, Z94.0, and Z99.2 were selected to identify renal impairment.
Fig 2
Fig 2. Regimen selection for induction therapy before SCT and post-SCT therapy in the SCT-conducted group.
(A) 2003 to 2015 induction therapy before SCT, (B) 2016 to 2020 induction therapy before SCT, (C) 2003 to 2015 post-SCT therapy, (D) 2016 to 2020 post-SCT therapy. DRd, daratumumab/lenalidomide/dexamethasone; IRd, ixazomib/lenalidomide/dexamethasone; IXA, ixazomib; KRd, carfilzomib/lenalidomide/dexamethasone; Rd, lenalidomide/dexamethasone; SCT, stem cell transplantation; VAD/VAd, vincristine/doxorubicin/dexamethasone; VCD/VCd, bortezomib/cyclophosphamide/dexamethasone; VD/Vd, bortezomib/dexamethasone; VRD/VRd, bortezomib/lenalidomide/dexamethasone. Note: Post-SCT therapy is the initiation date of the regimen between the date of SCT and post 4 months from SCT.
Fig 3
Fig 3. First-line treatment duration by selected regimen in SCT not-conducted group (All population).
MP, melphalan/prednisolone; Rd, lenalidomide/dexamethasone; VCd, bortezomib/cyclophosphamide/dexamethasone; Vd, bortezomib/dexamethasone; VMP, bortezomib/melphalan/predonisolone; VRd, bortezomib/lenalidomide/dexamethasone. Note: Top 5 regimens in the proportion of use were selected.
Fig 4
Fig 4
A: First-line treatment duration by selected regimen in SCT not-conducted group (aged >70 years). B: First-line treatment duration by selected regimen in SCT not-conducted group (aged ≤70 years). Cy+Dex, cyclophosphamide/dexamethasone; MP, melphalan/prednisolone; Rd, lenalidomide/dexamethasone; VCd, bortezomib/cyclophosphamide/dexamethasone; Vd, bortezomib/dexamethasone; VMP, bortezomib/melphalan/predonisolone; VRd, bortezomib/lenalidomide/dexamethasone. Note: Top 5 regimens in the proportion of use were selected.
Fig 5
Fig 5
A. Kaplan-Meier curve for time to inpatient death by the lines of treatment for SCT-conducted group in 2003–2015 and 2016–2020 cohorts. B. Kaplan-Meier curve for time to inpatient death by the lines of treatment for SCT not-conducted group in 2003–2015 and 2016–2020 cohorts. SCT, stem cell transplantation.
See this image and copyright information in PMC

References

    1. Raab MS, Podar K, Breitkreutz I, Richardson PG, Anderson KC. Multiple myeloma. Lancet. 2009; 374:324−339. doi: 10.1016/S0140-6736(09)60221-X - DOI - PubMed
    1. Uno S, Goto R, Suzuki K, Iwasaki K, Takeshima T, Ohtsu T. Current treatment patterns and medical costs for multiple myeloma in Japan: a cross-sectional analysis of a health insurance claims database. J Med Econ. 2020; 23(2):166−173. doi: 10.1080/13696998.2019.1686870 - DOI - PubMed
    1. Kim K, Lee JH, Kim JS, Min CK, Yoon SS, Shimizu K, et al.. Clinical profiles of multiple myeloma in Asia-An Asian Myeloma Network study. Am J Hematol. 2014; 89(7):751−756. doi: 10.1002/ajh.23731 - DOI - PubMed
    1. National Cancer Registry (Ministry of Health, Labour and Welfare), tabulated by Cancer Information Service, National Cancer Center, Japan. (2016–2018), 2021. Accessed July 19, 2022. https://ganjoho.jp/reg_stat/statistics/stat/summary.html
    1. Ozaki S, Handa H, Saitoh T, Murakami H, Itagaki M, Asaoku H, et al.. Evaluation of the Revised International Staging System (R-ISS) in Japanese patients with multiple myeloma. Ann Hematol. 2019; 98(7):1703−1711. doi: 10.1007/s00277-019-03702-1 - DOI - PubMed