Injectable Hypomethylating Agents for Management of Myelodysplastic Syndromes: Patients’ Perspectives on Treatment

Abstract

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Impact of Hypomethylating Agent Use on Hospital and Emergency Room Visits, and Predictors of Early Discontinuation in Patients With Higher-Risk Myelodysplastic Syndromes

“…30 A recent survey study assessed the experiences and challenges of IV/SC HMA use for MDS patients or their caregiver proxies. 32 Almost all of the 141 respondents in the study received treatment in a medical facility, and 43% traveled for 1 hour or more for treatment. Approximately 44% of patients reported experiencing a treatment delay; reasons varied but common reasons included not having time off work, and not having someone to accompany them or drive them to the treatment center.…”

“…Approximately 44% of patients reported experiencing a treatment delay; reasons varied but common reasons included not having time off work, and not having someone to accompany them or drive them to the treatment center. 32 Therefore, it is possible that, in some patients, discontinuation was due to practical and logistical challenges associated with the need to receive multiple consecutive HMA treatment cycles administered in a hospital or other treatment facility. 18 , 20 , 30 In the unadjusted analyses in our study, patients who discontinued HMA before 4 cycles were more likely to be single single/separated/divorced/widowed than those who continued therapy for ≥ 4 cycles, suggesting the possibility that this group may need more support in traveling to the treatment center.…”

“…Also of note, approximately 70% of patients surveyed indicated that oral treatment would definitely or probably interfere less with their lives than IV treatment, and over half indicated that it would definitely or probably make it easier for them to cope with their disease. 32 However, as the oral HMA decitabine and cedazuridine was only recently approved for use in the US, 33 the potential economic and healthrelated quality-of-life benefits for patients of an oral HMA over IV/SC treatment have yet to be established.…”

Patient Preferences for Benefits, Risks, and Administration Route of Hypomethylating Agents in Myelodysplastic Syndromes

“…In our other research, we also found that patients with MDS reported that treatment interferes with their regular daily activities, is not convenient and that financial barriers created delays and/or discontinuation of treatment. 47 This in turn has clinical and economic consequences, as a longer duration of HMA therapy may be associated with better overall survival outcomes 44 and the failure of HMA treatment is associated with increased healthcare burden. 45 , 13 , 46 The proportion of respondents predicted to choose an oral treatment option, when offered alongside other options, was > 75%.…”

“…This is consistent with the percentage of patients indicating they would prefer oral MDS treatment to IV/SC therapies (69%) reported in the treatment burden survey of MDS patients. 47 This suggests that up to 30% of patients may prefer to remain on IV/SC. This is not entirely surprising, as some patients may face few difficulties with treatment administration and may value the interaction with staff at the clinic.…”