Burden of Treatment-Induced Peripheral Neuropathy in Patients with Multiple Myeloma in Sweden

Acta Haematol. 2021;144(5):519-527. doi: 10.1159/000512165. Epub 2021 Feb 25.

Abstract

Introduction: Treatment-induced peripheral neuropathy (TIPN) is a complication of multiple myeloma (MM) treatment.

Objective: This real-world, retrospective study used electronic medical record (EMR) data from 3 Swedish clinics to assess the occurrence and economic burden of TIPN in patients with MM.

Methods: Eligible patients had an MM diagnosis in the Swedish Cancer Registry between 2006 and 2015 and initiated treatment during that period. Follow-up was until last EMR visit, death, or study end (April 2017). The current analyses included patients receiving bortezomib, lenalidomide, carfilzomib, or thalidomide at any treatment line. To discern healthcare resource utilization (HCRU) and costs associated with TIPN from other causes, patients with TIPN were matched with those without on baseline characteristics, treatment, and line of therapy. All analyses were descriptive.

Results: Overall, 457 patients were included; 102 (22%) experienced TIPN. Patients experiencing TIPN during first-line treatment mostly received bortezomib-based regimens (n = 48/57 [84%]); those with TIPN during second- and third/fourth-line treatment mostly received lenalidomide/thalidomide-based regimens (19/31 [61%], 8/14 [57%], respectively). Patients with TIPN had higher HCRU/costs than those without TIPN (mean differences in hospital outpatient visits: 5.2, p = 0.0031; total costs per patient-year: EUR 17,183, p = 0.0007).

Conclusions: Effective MM treatments associated with a reduced incidence of TIPN could result in decreased healthcare expenditure.

Keywords: Healthcare costs; Healthcare resource utilization; Multiple myeloma; Treatment-induced peripheral neuropathy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols* / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols* / adverse effects
  • Bortezomib / administration & dosage
  • Bortezomib / adverse effects
  • Cost of Illness*
  • Female
  • Humans
  • Incidence
  • Lenalidomide / administration & dosage
  • Lenalidomide / adverse effects
  • Male
  • Middle Aged
  • Multiple Myeloma / drug therapy
  • Multiple Myeloma / mortality
  • Oligopeptides / administration & dosage
  • Oligopeptides / adverse effects
  • Peripheral Nervous System Diseases* / chemically induced
  • Peripheral Nervous System Diseases* / mortality
  • Registries*
  • Retrospective Studies
  • Sweden
  • Thalidomide / administration & dosage
  • Thalidomide / adverse effects

Substances

  • Oligopeptides
  • Thalidomide
  • Bortezomib
  • carfilzomib
  • Lenalidomide