Lymphoma and Plasma Cell Disorders
Real world impact of treatment-induced peripheral neuropathy (TIPN) on patient reported outcomes (PROs) in patients with multiple myeloma (MM) in the United States.
Background: Some MM treatments can cause TIPN, which is associated with pain, burning, tingling and can impact multiple aspects of patients’ lives. This study examined the PRO impact of TIPN in MM patients using real world data in the US. Methods: Adults with ≥1 disease progression of MM and ≥1 Patient Care Monitor (PCM) records from the Vector Oncology Data Warehouse were included. Index scores (General Physical Symptoms, Treatment Side Effects, Acute Distress, Despair, Impaired Ambulation, and Impaired Performance) and 4 individual items (numbness/tingling; burning sensation in hands or feet; physical pain; and weakness of body parts) (0 not a problem –10 as bad as possible) were compared before and after the 1st TIPN occurrence using fixed effect models accounting for nesting within subjects. Results: 304 patients were included (mean age: 63.5; 50.3% male; ≥1 comorbidity conditions: 50.0%; renal disease: 24.3%; diabetes: 21.1%; cerebrovascular accident: 9.2%; congestive heart failure: 7.2%), 39.1% of whom had ≥1 TIPN during follow up. After the 1st TIPN occurrence, 2 index scores (General Physical Symptoms and Impaired Performance) and all 4 individual items investigated worsened statistically significantly in unadjusted analysis. Increased problems in Impaired Performance, numbness/tingling, and burning in hands or feet were clinically relevant (Table). Conclusions: Following TIPN events, MM patients experienced significant and clinically meaningful worsening of symptoms and performance in daily activities. Novel MM agents with lower TIPN rates might provide better patient quality of life and persistence.
|General Physical Symptoms||0.91Ɨ||0.27|
|Treatment Side Effects||-0.12||0.25|
|Burning in hands or feet||1.60*Ɨ||0.10|
|Weakness of body parts||0.64Ɨ||0.13|
*A ≥1.5-3 change in index score or ≥1.0 change in items are considered clinically relevant. Ɨp<0.05