Comparison of Two Therapeutic Regimes, Lenalidomide with Dexamethasone and Thalidomide with Dexamethasone, in the Treatment of Multiple Myeloma at a Tertiary Care Hospital in India

Sashidharan, Nithin; Shenoy, Smita; K, Meena Kumari; Thanusubramanian, Harish

doi:10.7860/jcdr/2015/11798.5895

Cited by 2 publications

(3 citation statements)

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“…An observational retrospective study conducted in India (analysis of medical record files) compared the efficacy and occurrence of adverse events in 17 patients (newly diagnosed MM) that had received thalidomide-dexamethasone with 19 patients treated with lenalidomide-dexamethasone 18 . The authors found no difference between thalidomide-and lenalidomide-based therapies with respect to efficacy and safety 21 . A recent population-based cohort study by Luo et al 22 compared survival and rates of peripheral neuropathy in MM patients (n = 1264) receiving either thalidomide or lenalidomide in routine care in the US.…”

Section: Comparative Effectiveness Of Thalidomideversus Lenalidomide-mentioning

confidence: 87%

“…Lenalidomide, thalidomide and proteasome inhibitors (bortezomid) are effective drugs that have revolutionized the treatment of MM. Comparative effectiveness research failed to demonstrate a greater efficacy of lenalidomide over thalidomide or bortezomid in patients with MM [18][19][20][21]23 . All these drugs can cause potentially severe adverse effects but their toxicity profiles are somewhat different from each other.…”

Section: Discussionmentioning

confidence: 99%

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The tale of lenalidomide clinical superiority over thalidomide and regulatory and cost-effectiveness issues

Paumgartten

2019

Ciênc. saúde coletiva

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In April 2017, the National Sanitary Surveillance Agency (ANVISA-Brazil) approved lenalidomide (LEN) for multiple myeloma (MM) and myelodysplastic syndrome. ANVISA had rejected the first application in 2010, and denied a request for reconsideration in 2012. The reason for rejection was the lack of comparative effectiveness studies proving that LEN was more effective than thalidomide (THAL), a strictly controlled drug regulated by Federal law 10.651/2003 and dispensed to patients (at no costs) through public health system units and hospitals. ANVISA unexplained retreat on the LEN approval for marketing was an unquestionable triumph of the lobbying that ensued the denial, at the forefront of which were politicians, Congress members, patient organizations and medical societies. Two randomized (phase III) trials and three observational (case-control and population-based cohort) compared the effectiveness of THAL- versus LEN-based therapies in MM. Overall, these studies showed no difference in efficacy between LEN- and THAL-based therapies. LEN caused less neuropathy, and more severe hematologic adverse effects. It is much costlier than THAL, and substitution of THAL by LEN shall raise considerably public healthcare costs in Brazil.

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Section: Comparative Effectiveness Of Thalidomideversus Lenalidomide-mentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

The tale of lenalidomide clinical superiority over thalidomide and regulatory and cost-effectiveness issues

Paumgartten

2019

Ciênc. saúde coletiva

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“…Multiple myeloma is a heterogeneous plasma cell dyscrasis, characterized by clonal plasma cells infiltration, presence of M-paraprotein, and an associated end organ failure. MM is incurable disease with varied survival range and an overall median survival of 3-4 years (Sashidharan et al, 2015). A large multicentre study conducted in 2005, provided the base of ISS staging system, showed median survival for patients with ISS stages I, II and III as 62, 44 and 29 months respectively (Greipp et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

International Scoring System in Symptomatic Multiple Myeloma: Experience from a Tertiary Care Center

Sultan

Irfan²,

Parveen³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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Background: Symptomatic multiple myeloma (MM) is an acquired B-cell malignant proliferation of antibody secreting plasma cells, characterized by end organ damage due to monoclonal immunoglobulin secretion. The aim of this study wa to determine the stage stratification according to an international scoring system in adult Pakistani MM patients at presentation. Materials and Methods: This single centre retrospective study extendedfrom January 2012 to December 2015. Data were retrieved from the departmental maintained records. Results: A total of 39 patients were diagnosed at our center with MM during the period of the study, 25 males and 14 females. Age ranged between 36 and 81 with a mean of 54.5±14.8 and a median of 57 years. Common presenting complaints included fatigue (80.9%), backache (79.3%) and bone pain (66.2%). Overall, 9 patients were in ISS stage I (23%), 12 were in stage II (30.7%) and 18 were in stage III (46.1%). Out of the total, 29 (74.3%) had kappa immunoglobulin andthe remaining 10 (25.6%) had lambda type myelomas. IgG myeloma was commonest, seen in 26 (66.6%) followed by IgA in 11 (28.2%) with non secretory myeloma in one (2.5%) and light chain disease also in one patient (2.5%). Conclusions: MM in Pakistani patients is seen in a relatively young population with male predominance. Primarily patients are symptomatic and risk stratification revealed a predominance of advanced stage III disease in our setting.

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Comparison of Two Therapeutic Regimes, Lenalidomide with Dexamethasone and Thalidomide with Dexamethasone, in the Treatment of Multiple Myeloma at a Tertiary Care Hospital in India

Cited by 2 publications

References 15 publications

The tale of lenalidomide clinical superiority over thalidomide and regulatory and cost-effectiveness issues

The tale of lenalidomide clinical superiority over thalidomide and regulatory and cost-effectiveness issues

International Scoring System in Symptomatic Multiple Myeloma: Experience from a Tertiary Care Center

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