PF727 DOES QUALITY OF LIFE IN MULTIPLE MYELOMA PATIENTS DIFFER BETWEEN NATIONALITIES? A EUROPEAN MULTINATIONAL STUDY
Authors: A. Van Dongen - Leunis, E. Valent, K. Morgan, A. Sajjad, R. Troia, A. Vallejo, P. Sonneveld, K. Redekop
Journal: HemaSphere (2019)

Background: In multiple myeloma (MM) patients, quality of life is a relevant outcome parameter due to the chronic nature of the disease. Therefore, clinical trials are now more often including quality of life as a secondary outcome measure. Multinational studies usually pool quality of life estimates without evaluating potential differences between nationalities. Although studies in other disease areas have shown that quality of life scores differ between countries. Whether differences in nationalities also account for variation in quality of life in MM is still unknown. Aims: The aim of this study is to evaluate whether MM-specific quality of life differs between nationalities within Europe. Methods: All MM patients were eligible to participate in an online survey, irrespective of age, disease status and current treatment. By applying no restrictions, this study assessed quality of life in a real-world population in contrast to most clinical trial populations, which are selected using strict eligibility criteria. The online questionnaire consisted of a generic and disease-specific quality of life measure (EQ-5D-5L and EORTC QLQ-C30) and questions related to specific disease and patient characteristics (such as demographics, treatment phase, current treatment etc.). The questionnaire was translated into four languages (Dutch, English, German and French), using official translations of the EQ-5D-5L and QLQ-C30. The questionnaire was distributed through information channels of Myeloma Patients Europe (MPE). Quality of life was measured at a single time point. Multivariate regression analyses were performed to assess whether quality of life was associated with nationality, age, gender, treatment type, previous SCT and participation in a clinical study. All analyses were performed with a significance level of 0.10. Results: The analyses were restricted to nationalities consisting of at least 10 patients, including the German (N = 144), British (N = 58), Dutch (N = 58), Belgian (N = 26) and French (N = 10) nationality. A total of 296 patients were included in the analysis. The average age was 59 years (range: 33–87 years). The average EQ-5D-5L utility was 0.67 (95% CI: 0.64–0.70) and the average Global Quality of Life score of the QLQ-C30 (Global QoL) was 62 (95% CI: 59–65). Quality of life did not differ significantly between treatment modalities or treatment phases. The average EQ-5D-5L utility ranged from 0.64 (95% CI: 0.57–0.71) for British patients to 0.74 (95% CI: 0.59–0.91) for French patients. The average Global QoL score of the QLQ-C30 was 62 (95% CI: 59–65) and ranged between 60 (95% CI: 55–64) for German patients and 69 (95% CI: 54–84) for French patients. After correcting for patient and disease characteristics, Dutch and Belgian patients reported a significantly higher EQ-5D-5L utility than German and British patients (Dutch vs German: ß = 0.098, P-value = 0.039, Dutch vs British ß = 0.110, P-value = 0.051, Belgian vs German ß = 0.125, P-value = 0.078, Belgian vs British ß = 0.136, P-value = 0.076). Similar differences between nationalities were found for the Global QoL score. Summary/Conclusion: Quality of life in MM patients differs between nationalities across Europe. German patients report lower quality of life than Dutch and Belgian patients; British patients also report lower quality of life than Dutch patients. Multinational studies should consider potential differences in quality of life between nationalities. Furthermore, future studies need to validate these findings and identify reasons for the differences between nationalities.