Conference Correspondent

The Significant Contribution of Pain in Determining the Health Status of Patients with Multiple Myeloma

Conference Correspondent 

Bone lesions and bone pain are relatively common in patients with multiple myeloma (MM). Pain can be debilitating; therefore, patient-reported outcomes may provide useful information in determining the impact of this condition. This study assessed health status using the EQ-5D, a commonly used tool to measure health utility scores. It also evaluated the predictive information provided by the Brief Pain Inventory (BPI), a self-report pain assessment tool designed to capture pain severity and interference in patients.

Eligible patients had histologically confirmed advanced cancers, radiographic evidence of ≥1 bone metastasis, an Eastern Cooperative Oncology Group status score of ≥2, and adequate organ function. These patients completed the EQ-5D and BPI at baseline. Using data from 168 patients, researchers summarized information about the patients’ health-related quality of life and utility scores. The investigators also analyzed the same data from several (N = 5500) groups of patients with cancer, including breast and prostate cancers, to determine whether patients with MM have experiences similar to patients with other types of cancer.

Of the 5 dimensions measured by the EQ-5D, patients with some/moderate or extreme MM-related pain (80%) scored the highest (higher score denotes greater severity), followed by usual activities (68%), mobility (64%), anxiety/depression (50%), and self-care (36%). The order was similar for patients with other cancers, but with slightly lower percentages for most items: pain (79%), usual activities (58%), mobility (55%), anxiety/depression (58%), and self-care (26%). When the BPI was used as a surrogate marker, there was considerable concordance with EQ-5D scores. Concordance index scores were 86% for mobility, 80% for self-care, 83% for usual activities, 90% for pain, and 78% for anxiety/depression, where 100% represented total concordance and 0% represented no concordance. Three BPI pain severity items—pain at its worst, average pain, and pain now—in addition to interference with activity and interference with work significantly predicted the EQ-5D pain item.

In conclusion, researchers reported that a majority of the patients reported moderate to extreme problems in all EQ-5D dimensions except self-care. Consistent results were seen across tumor types, including breast and prostate. Concordant results with the EQ-5D indicated that use of the BPI had utility for treatment planning and health status evaluation in patients with MM.

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