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We examined real\u2010world toxicity of second\u2010line ipilimumab compared to standard second\u2010line treatments prior to funding. MM patients who received systemic treatment from April 2005 to March 2015 were included. Patients receiving second\u2010line ipilimumab after September 2012 were considered as cases, and those who received second\u2010line treatment prior to the funding date were included as historical controls. Outcomes assessed include treatment\u2010related mortality, any\u2010cause hospital visits, ipilimumab\u2010related hospital visits and specialist visits (eg, endocrinologists, ophthalmologists, gastroenterologists, rheumatologists and respirologists), which were captured from up to 30 and\/or 90\u2009days after end of second\u2010line treatment. Inverse probability of treatment weighting was used to adjust for baseline differences between groups. Odds ratios (ORs) from logistic regressions and rate ratios (RRs) from rate regressions were used to assess differences between groups. We identified 329\u2009MM patients who received second\u2010line treatments (ipilimumab: 189; controls: 140). Ipilimumab was associated greater any\u2010cause (60.1% vs 45.7%; OR = 1.81; <jats:italic>P<\/jats:italic> value = .019) and ipilimumab\u2010related (47.2% vs 31.9%; OR = 1.91; <jats:italic>P<\/jats:italic> value = .011) hospital visits. Adjusting for different follow\u2010up days, ipilimumab was associated with higher rates of all\u2010cause (RR = 1.56 [95%CI: 1.12\u20102.16]), and ipilimumab\u2010related (RR = 2.18 [95% CI: 1.45\u20103.27]) hospital visits. Patients receiving ipilimumab were more likely to visit specialist involved in immunotherapy toxicity management (23.5% vs 13.7%; <jats:italic>P<\/jats:italic> value = .04). Compared to historical second\u2010line treatments, second\u2010line ipilimumab was associated with more health service utilization (specifically hospital visits and specialist visits), suggestive of potentially increased toxicity in the real world.<\/jats:p>","DOI":"10.1002\/ijc.33357","type":"journal-article","created":{"date-parts":[[2020,10,26]],"date-time":"2020-10-26T19:45:36Z","timestamp":1603741536000},"page":"1910-1918","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Real\u2010world, population\u2010based cohort study of toxicity and resource utilization of second\u2010line ipilimumab for metastatic melanoma in Ontario, Canada"],"prefix":"10.1002","volume":"148","author":[{"given":"Wei Fang","family":"Dai","sequence":"first","affiliation":[{"name":"Provincial Drug Reimbursement Program Ontario Health (Cancer Care Ontario)  Toronto Ontario Canada"},{"name":"Canadian Centre for Applied Research in Cancer Control  Toronto Ontario Canada"},{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaclyn","family":"Beca","sequence":"additional","affiliation":[{"name":"Provincial Drug Reimbursement Program Ontario Health (Cancer Care Ontario)  Toronto Ontario Canada"},{"name":"Canadian Centre for Applied Research in Cancer Control  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Croxford","sequence":"additional","affiliation":[{"name":"ICES  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wanrudee","family":"Isaranuwatchai","sequence":"additional","affiliation":[{"name":"Canadian Centre for Applied Research in Cancer Control  Toronto Ontario Canada"},{"name":"Centre for Excellence in Economic Analysis Research St Michael's Hospital  Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ines B.","family":"Menjak","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Odette Cancer Centre Sunnybrook Health Sciences Centre  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa M.","family":"Petrella","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Odette Cancer Centre Sunnybrook Health Sciences Centre  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Mittmann","sequence":"additional","affiliation":[{"name":"Odette Cancer Centre Sunnybrook Health Sciences Centre  Toronto Ontario Canada"},{"name":"Pharmacology &amp; Toxicology University of Toronto  Toronto Ontario Canada"},{"name":"Canadian Agency for Drugs and Technologies in Health  Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig C.","family":"Earle","sequence":"additional","affiliation":[{"name":"ICES  Toronto Ontario Canada"},{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Gavura","sequence":"additional","affiliation":[{"name":"Provincial Drug Reimbursement Program Ontario Health (Cancer Care Ontario)  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca E.","family":"Mercer","sequence":"additional","affiliation":[{"name":"Provincial Drug Reimbursement Program Ontario Health (Cancer Care Ontario)  Toronto Ontario Canada"},{"name":"Canadian Centre for Applied Research in Cancer Control  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy P.","family":"Hanna","sequence":"additional","affiliation":[{"name":"Division of Cancer Care and Epidemiology Queen's University Cancer Research Institute  Canada"},{"name":"Department of Oncology Queen's University  Kingston Ontario Canada"},{"name":"ICES, Queen's University  Kingston Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2501-3057","authenticated-orcid":false,"given":"Kelvin K. W.","family":"Chan","sequence":"additional","affiliation":[{"name":"Provincial Drug Reimbursement Program Ontario Health (Cancer Care Ontario)  Toronto Ontario Canada"},{"name":"Canadian Centre for Applied Research in Cancer Control  Toronto Ontario Canada"},{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Odette Cancer Centre Sunnybrook Health Sciences Centre  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1003466"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22427"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23086"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.17.8954"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2013.31.15_suppl.3018"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.60.8448"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00262-018-2219-8"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/CAD.0000000000000629"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2016.024"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2015.4069"},{"issue":"11","key":"e_1_2_11_12_1","first-page":"6303","article-title":"Long\u2010term survival with ipilimumab: experience from a national expanded access program for patients with melanoma","volume":"35","author":"Krajsov\u00e1 I","year":"2015","journal-title":"Anticancer Re"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14633"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/1120009X.2017.1311444"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12032-018-1084-9"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318229360e"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2004.03.012"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2011.568786"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X09341755"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2015.1062356"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-016-0152-y"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30608-9"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2018.03.012"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.02035"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-016-2309-y"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-017-2453-z"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-020-06798-1"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2020-000604"}],"container-title":["International Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.33357","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijc.33357","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.33357","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T21:52:33Z","timestamp":1693691553000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ijc.33357"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,7]]},"references-count":27,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2021,4,15]]}},"alternative-id":["10.1002\/ijc.33357"],"URL":"https:\/\/doi.org\/10.1002\/ijc.33357","archive":["Portico"],"relation":{},"ISSN":["0020-7136","1097-0215"],"issn-type":[{"value":"0020-7136","type":"print"},{"value":"1097-0215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,7]]},"assertion":[{"value":"2020-06-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}