Burden of Treatment, Treatment Sequencing and Healthcare Resource Utilization in Multiple Myeloma in Latin America: A Targeted Literature Review

拉丁美洲多发性骨髓瘤的治疗负担、治疗顺序和医疗资源利用情况:一项有针对性的文献综述

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Abstract

Approval of key drug classes has improved survival for patients with multiple myeloma (MM). However, most patients experience relapse or become refractory to these treatments, with retreatment having limited efficacy. Access to these key treatments varies widely across countries in Latin America (LATAM), which can lead to suboptimal clinical outcomes. This targeted literature review aimed to understand the epidemiology, burden of treatment, treatment sequencing and availability for MM in Argentina, Brazil, Chile, Colombia and Mexico, exploring recent literature on patient and clinical outcomes, and healthcare resource utilization (HCRU), in these countries. A literature search was conducted using four literature databases: PubMed, Embase, SciELO and LILACS (timeframe: 1 January 2014-1 November 2024). Articles of interest reported on patients with MM in the relevant LATAM countries focusing on epidemiology, any therapy for MM, treatment patterns, patient and clinical outcomes and HCRU. Findings were analyzed by geography, line of therapy and intervention, where data were available. Of 878 articles identified, 40 reported on outcomes of interest, which were mostly retrospective observational studies (n = 33). Epidemiology reported in these studies largely aligned with global data but varied across the countries. Treatments varied by country and healthcare settings, with newer drugs (such as lenalidomide, daratumumab, bortezomib) more likely to be used in private than public healthcare settings. Survival outcomes were variable and greater in private versus public healthcare settings. Adverse events were inconsistently reported across studies; generally, few events were serious or severe. HCRU was seldom reported. Overall, this review revealed a high variability in treatment patterns, limited availability of globally accepted standard of care treatments and disparate outcomes in countries in LATAM. Furthermore, we identified substantial gaps in the literature; filling these knowledge gaps in treatment utilization and outcomes may provide pathways to improving access for newer, more effective therapies, alleviating the substantial burden of MM in LATAM.

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