{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T20:51:35Z","timestamp":1772139095420,"version":"3.50.1"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T00:00:00Z","timestamp":1621987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Takeda Pharmaceuticals"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>We aimed to provide real-world information on survival, health care resource utilization (HCRU), and expenditures related to various first lines of therapy (1LOTs) in newly diagnosed multiple myeloma (NDMM) patients who were transplant ineligible (TI).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Patients and methods<\/jats:title>\n<jats:p>From the Taiwan National Health Insurance Database (2008\u20132016), we identified 1,511 NDMM-TI patients who had received 1LOT since June 2012. We categorized 1LOT regimens into four groups: bortezomib (V)+thalidomide (T), V, T, and non-V\/T. Patients\u2019 characteristics were collected. The overall survival (OS), event-free survival (EFS), frequencies of HCRU (hospitalization, visiting outpatient and emergency departments), and related expenditures within one year after commencement of the 1LOT were evaluated and compared.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The mean age of the included patients was 71.3 (SD 10.7) years, and 40.4% of patients had a CCI score \u22653. Most patients (747; 49.4%) were in the V+T group and, after adjusting for covariates, had a significantly longer OS (median, 22.2 months) and EFS (9.1 months) than those in the T group (12.6 and 4.5 months, respectively) and the non-V\/T group (12.2 and 3.2 months, respectively), but they were mostly comparable with patients in the V group (23.8 and 6.6 months, respectively). Compared to those in the V+T group, patients in the T and non-V\/T groups had 29% and 39% fewer outpatient visits and 15% and 24% lower total expenditure, respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our real-world data consolidate evidence for the effectiveness of bortezomib-containing regimens as the 1LOT in NDMM-TI patients at the expense of more outpatient visits and higher total costs.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0252124","type":"journal-article","created":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T17:40:49Z","timestamp":1622050849000},"page":"e0252124","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Survival, health care resource utilization and expenditures of first-line treatments for multiple myeloma patients ineligible for transplant in Taiwan"],"prefix":"10.1371","volume":"16","author":[{"given":"Chih-Ning","family":"Cheng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shang-Yi","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei-Wen","family":"Lien","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih-Ting","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8249-7481","authenticated-orcid":true,"given":"Fang-Ju","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,5,26]]},"reference":[{"issue":"12","key":"pone.0252124.ref001","doi-asserted-by":"crossref","first-page":"e538","DOI":"10.1016\/S1470-2045(14)70442-5","article-title":"International 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MM-020) for transplant-ineligible patients with newly-diagnosed multiple myeloma","volume":"61","author":"FA Sharpley","year":"2020","journal-title":"Leuk Lymphoma"},{"key":"pone.0252124.ref029","doi-asserted-by":"crossref","first-page":"143","DOI":"10.2147\/RMHP.S97248","article-title":"Multimorbidity in chronic disease: impact on health care resources and costs","volume":"9","author":"SM McPhail","year":"2016","journal-title":"Risk Manag Healthc Policy"},{"issue":"10","key":"pone.0252124.ref030","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1016\/S1470-2045(10)70187-X","article-title":"Bortezomib, melphalan, and prednisone versus bortezomib, thalidomide, and prednisone as induction therapy followed by maintenance treatment with bortezomib and thalidomide versus bortezomib and prednisone in elderly patients with untreated multiple myeloma: a randomised trial","volume":"11","author":"MV Mateos","year":"2010","journal-title":"Lancet Oncol"},{"issue":"3","key":"pone.0252124.ref031","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s11936-018-0618-y","article-title":"Cardiovascular Complications of Multiple Myeloma Treatment: Evaluation, Management, and Prevention","volume":"20","author":"DH Lee","year":"2018","journal-title":"Curr Treat Options Cardiovasc Med"},{"issue":"9","key":"pone.0252124.ref032","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.3324\/haematol.2018.191288","article-title":"Cardiovascular adverse events in modern myeloma therapy\u2014Incidence and risks. A review from the European Myeloma Network (EMN) and Italian Society of Arterial Hypertension (SIIA)","volume":"103","author":"S Bringhen","year":"2018","journal-title":"Haematologica"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0252124","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T17:41:27Z","timestamp":1622050887000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0252124"}},"subtitle":[],"editor":[{"given":"Sreeram V.","family":"Ramagopalan","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,5,26]]},"references-count":32,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5,26]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0252124","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,26]]}}}