Incidence of corneal adverse events in patients with multiple myeloma and their clinical and economic impact: A real-world retrospective cohort study

Abstract

Aims

Ocular toxicities are common adverse events (AEs) associated with anticancer agents. There is a paucity of data documenting their impact on patient care. This study assessed the clinical and economic burden of corneal AEs and related symptoms (collectively termed corneal AEs) in patients receiving multiple myeloma (MM) treatment.

Materials and Methods

Adults with a newly diagnosed MM (MM cohort) were identified from PharMetrics Plus, a US insurance claims database. Incidence, outpatient (OP) care, emergency department (ED) visits, hospitalizations, and costs were assessed for corneal AEs of interest: keratopathy/keratitis, blurred vision/decreased acuity, dry eye, eye pain, and photophobia. Incidence of new corneal AEs, healthcare resource utilization (HCRU), corneal AE-related HCRU, and costs were assessed and benchmarked against a hematology cohort of patients.

Results

The MM cohort included 2,120 patients with a median follow-up of 734.5 days. Overall, 11.7% of patients in the MM cohort and 7.4% in the hematology cohort had ≥1 corneal AE of interest. In the MM cohort, dry eye (6.1%), blurred vision/decreased acuity (3.4%), and keratopathy/keratitis (2.5%) were the most frequent. The overall median corneal AE-related per-patient-per-month (PPPM) cost was $27, predominantly contributed by OP care (median $19 PPPM). During follow-up, 4.8% of patients visited the ED, 3.6% were hospitalized, and 42.5% of patients visited an ophthalmologist/optometrist (∼1.69 visits/year). Costs of these visits were negligible (median PPPM $19) compared to total all-cause costs (median PPPM $17,286).

Limitations

The results can only be generalized to commercially insured and Medicare Advantage patients. Claims-based diagnosis of corneal AEs may underestimate true incidences.

Conclusions

Corneal AEs were observed in ∼12% of patients in the MM cohort, the most common were keratopathy/keratitis, dry eye, and blurred vision. Most of them required only OP care. The clinical and economic burden for treating corneal AEs was low when compared with total all-cause or MM-related PPPM costs.

Keywords:

• Multiple myeloma
• corneal adverse events
• real-world
• toxicity
• hematology
• economic burden
• healthcare resource utilization

JEL Classification Codes:

• I10
• I1
• I
• I00

Transparency

Declaration of Funding

This study was funded by GlaxoSmithKline [208295].

Declaration of financial/other relationships

FW, SF, EMM, JW, and LS are all GSK employees and have stocks and/or shares in GSK. C-CC and KS are employees of IQVIA, which receives consulting fees/research funding from GSK. SN was an employee of IQVIA at the time of study design and initiation. DMK has received consulting fees from GSK and Triphase Accelerator US Corporation, has a management role in Calm Water Therapeutics LLC, and has stock and/or shares in Eyeon Therapeutics, Inc. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

GSK contributed to the study design, implementation, data collection, interpretation, and analysis. Medical writing support was provided by Crystal Kraft, PhD, of Fishawack Indicia Ltd, UK, funded by GSK.

Data availability statement

GSK makes available anonymized individual participant data and associated documents from interventional clinical studies which evaluate medicines, upon approval of proposals submitted to www.clinicalstudydatarequest.com. To access data for other types of GSK sponsored research, for study documents without patient-level data, and for clinical studies not listed, please submit an enquiry via the website.

Ethics approval and consent to participate

This study complied with all applicable laws regarding participant privacy. During this study, there was no direct contact with any of the study participants or primary collection of individual human data. Study results were presented in a tabular form and aggregate analyses did not include subject identifiers. Therefore, informed consent, ethics committee approval, or IRB approval were not required for this study.