Back to Journals » Patient Preference and Adherence » Volume 12

Treatment of relapsed refractory multiple myeloma: which new PI-based combination treatments do patients prefer?

Authors Wilke T, Mueller S, Bauer S, Pitura S, Probst L, Ratsch BA, Salwender H

Received 8 August 2018

Accepted for publication 29 September 2018

Published 9 November 2018 Volume 2018:12 Pages 2387—2396


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Thomas Wilke,1 Sabrina Mueller,2 Sabine Bauer,2 Silvia Pitura,3 Leona Probst,3 Boris A Ratsch,3 Hans Salwender4

1Institut für Pharmakoökonomie und Arzneimittellogistik (IPAM), 23966 Wismar, Germany; 2Ingress-Health, 23966 Wismar, Germany; 3Takeda Pharma Vertrieb GmbH & Co. KG, 10117 Berlin, Germany; 4Asklepios Kliniken Hamburg GmbH, 22763 Hamburg, Germany

Background and objectives: This study describes preferences of German relapsed refractory multiple myeloma (RRMM) patients with novel proteasome inhibitor-based combination treatments.
Methods: Patients with a minimum age of 18 years and a diagnosis of RRMM were included. Their preferences were assessed using a discrete choice experiment design, which was developed based on a literature review and two patient focus group discussions. The final discrete choice experiment design consisted of four attributes, namely “therapy application regimen,” “time without progression of disease,” “possibility of grade ≥3 adverse events (AEs) affecting the blood,” and “possibility of grade ≥3 AE heart failure.”
Results: Analysis was based on 84 patients (36.9% females, mean age 62.7 years, mean multiple myeloma disease duration 5.5 years). Among the tested attributes, “therapy application regimen” was assigned the highest importance for treatment decisions (38.8%), the second important attribute was “time without progression of disease” (38.7%), followed by “possibility of AE heart failure” (13.9%) and “possibility of AEs affecting the blood” (8.6%). Patients preferred oral intake once a day and once a week over other application modes such as oral intake once a day and once a week plus twice-weekly infusions. Furthermore, they preferred longer disease progression-free time and lower risk of grade ≥3 AEs. The highest overall utility was derived for ixazomib + lenalidomide + dexamethasone (utility: 3.218), compared with lenalidomide + dexamethasone (2.769), and carfilzomib + lenalidomide + dexamethasone (1.928).
Conclusion: RRMM patients prefer treatments with an all-oral application, a longer disease-progression-free time, and a lower probability of AEs. If patients face tradeoffs, they accept a lower progression-free time and/or higher AE rates to get an all-oral therapy.

Keywords: MM patient’s treatment preferences, relapsed refractory multiple myeloma, RRMM, discrete choice experiment, DCE

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]