Daratumumab for refractory or relapsed multiple myeloma : meta-analysis in red. Daratumumab en el manejo del mieloma múltiple refractario o recidivante : metaanálisis en red.

Abstract

Background: Refractory or recurrent multiple myeloma is a challenge for treating physicians. At present there are multiple therapeutic options for these cases, however the scientific evidence on their comparative effectiveness is still under construction. Objective: To compare, through a network meta-analysis, the efficacy and safety reported in clinical trials of daratumumab against other treatments in patients with relapsed or refractory multiple myeloma. Methodology: A systematic search of the literature was carried out through databases for the identification of clinical trials that evaluated the therapeutic effects of health technologies used in the management of refractory or recurrent multiple myeloma that had a common comparator with daratumumab. Subsequently, a meta-analysis network was carried out to compare the effectiveness, indirect comparisons were adjusted. ORs and their confidence intervals were estimated. Results: Seven clinical trials were included in the meta-analysis. When the common comparator was bortezomib/dexamethasone, daratumumab was superior compared to carfilzomib (OR 0.49, IC95% 0.99, 0.7) and bortezomib/dexamethasone (OR 0.26, IC95% 0.54, 0.37). When the common comparator was lenalidomide/dexamethasone, daratumumab was superior to carfilzomib (OR 0.21, IC95% 0.13, 0.36), ixazomib (OR 0.4, IC95% 0.26, 0.83) and elotuzumab (OR 0.28, IC95% 0.18, 0.44) on disease progression or death. Severe adverse reactions were similar between the groups. Conclusion: Daratumumab is a therapeutic tool that shows superior results in terms of disease progression or death and with a similar proportion of severe adverse reactions compared to other therapeutic alternatives.