Association of Socioeconomic Status with Adherence, Progression Free and Overall Survival to Oral Agents in Multiple Myeloma Patients
The introduction of novel oral immunomodulatory drugs has improved overall survival (OS) rates of patients with multiple myeloma (MM). Poor adherence to oral therapies may lead to drug resistance, poor response to treatment and other untoward effects. The purpose of this study was to examine the impact of socioeconomic status (SES) on adherence to oral MM medications, progression-free survival (PFS) and OS.
We created SES bands based on the American Community Survey (ACS) and the Behavioral Risk Factor Surveillance System (BRFSS) data and combined “Very Low” and ‘Low” and “Very High” and “High” into “Low” and “High” categories, respectively. We measured adherence using the medication possession ratio (MPR), calculated as the total days supplied in the period/length of the period; we defined optimal adherence as an MPR ≥ 0.8. We computed PFS for the entire cohort and defined it as the time from inclusion until the first date of visit with an ICD-10 code of C90.X3 indicting relapse, or date of death, whichever occurred first.
SES was not associated with adherence, PFS or OS in this study. However, adherent patients experienced significantly longer PFS and OS. To the authors’ knowledge, this is the first study evaluating drug adherence in MM oral agents across the United States. Future studies are needed to determine risk factors influencing non-adherence to oral MM agents so that vulnerable patients are identified and corrective actions are taken to maximize adherence and increase therapeutic success.
ASH 2022: Abstract #4522
W. Cliff Rutter, PharmD, PhD, Elisea Avalos-Reyes, PhD, Will Cavers, MSc, Shivaani Prakash, MSc, PhD, Kjel Johnson, PharmD and Leon Bernal-Mizrachi, MD
Doctor Bio:
Dr. Leon Bernal-Mizrachi is an Associate Professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine. Dr. Bernal serves as the Emory Section Chief of Hematology and Medical Oncology at Grady Health Systems. Board certified in medical oncology and internal medicine, he is a clinical member of the comprehensive care team treating leukemia patients at Grady.
