Subcutaneous or intravenous bortezomib in the treatment of multiple myeloma. Impact on peripheral neuropathy and cost

• Autores: G. A. Sánchez-Robles, Lourdes Álvarez Ayuso, B. Rodríguez Marrodán, D. Morillo Giles, I. Krsnik Castello
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 16, Nº. 6, 2014, págs. 4-4
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Background: Clinical trials have shown that subcutaneous (SC) bortezomib administration is an alternative to intravenous (IV) administration that is equally effective, presumably safer and more convenient for patients as well as cost-effective.

    Objective: To analyze the possible differences between IV and SC bortezomib administration as regards safety [incidence and severity of peripheral neuropathy (PN)] and costs.

    Method: Patients with multiple myeloma treated with bortezomib were divided into three roups according to the route of administration: group 1 (IV alone), group 2 (IV+SC) and group 3 (SC alone). We analyzed retrospectively the incidence and severity of PN, its relationship to other diseases and associated treatments. We also carried out a cost minimization study for both routes, considering only direct costs.

    Results: We analyzed 84 patients, who received a total of 1,587 doses. SC administration allowed patients to receive more doses and milligrams of bortezomib (p = 0.009 and p = 0.011, respectively). Twenty-nine patients (34.5%) developed PN; the highest proportion was observed in group 2 (50%, p = 0.051). PN was 1.6-fold more frequent in patients who had previously received thalidomide or bortezomib. There were no cases of severe PN among patients who received only SC bortezomib (p = 0.028). In group 3, PN did not result in treatment changes, whereas in group one, 13 patients had to interrupt or modify their regimens. SC administration allowed saving €80,082 during the study period, or around €17,800/year.

    Conclusion: SC bortezomib, compared to IV administration, decreases the incidence and severity of PN, avoids modifications in posology and results in a substantial reduction in healthcare costs