APLUSA-blog

MDS: Treatment paradigms are changing

Written by Siegfried ERTL | Apr 7, 2021 1:34:46 PM

MyeloDysplastic Syndromes: our syndicated research will tell you why - and how - treatment paradigms are changing. Our results from first 2 waves conducted are available now and field is running for the 3rd wave. 

What do we see from the most recent results?  

  • A vast majority of low-to-intermediate risk MDS patients who are now treated for their anemia needed to be treated as soon as within their first year since MDS diagnosis. The dominant first treatments are ESAs or RBC-T, often combined. HMAs, lenalidomide or immunosuppressants are rather used in exceptions, and preferences of choice differ between countries. But treatment paradigms are changing with the introduction of new drugs and we will continue to monitor this market in the coming months. 
  • Looking at patient record forms we observe a change in the market due to new treatment alternatives. Luspatercept is for example available in first countries with significant uptake of shares. As a consequence treatments with ESAs decline.
  • This comes as no surprise, as many patients have already (very) high EPO levels when starting their ESA treatment. Furthermore, patient’s response to ESA treatment becomes in many cases unsatisfactory within few months after the 1st ESA injection.
  • We also reveal that revised IPSS prognostic system (IPSS-R) is not yet consistently used across countries: although the IPSS-R provides useful advances and more discriminatory prognostic risk assessment compared to “older” IPSS, it is not consistently used across countries. In our syndicated research conducted across the globe, it appears that only in few countries most of the MDS treating physicians predominantly use IPSS-R, and in others only around half. 

Every quarter we collect about 1,000 patient record forms of anonymized patients, all with low-to-medium risk* MDS who present with anemia requiring treatment. *(low to medium risk MDS being defined as “very low, low and intermediate” in IPSS-R or “low risk to Int-1” in IPSS)

These patient record forms are collected from hematologists and onco-hematologists across up to 10 countries.

About half of low-to-medium risk MDS patient charts collected were diagnosed within the last year or less. We observe details of transfusion dependent and not-dependent patients, collect the number of blood transfusions and units of transfusion over the past 8 weeks and half year, as well as the change in Hb level compared to the treatment goal. All this can be tracked on a individual patient basis.

Our results include shares and sequences of treatments with the following treatments and the introduction of new therapies approved:  

  • Red Blood Cell transfusion (RBC-T) 
  • Iron chelating agents 
  • Erythropoiesis-stimulating agents 
  • Hypomethylating agents (HMAs) 
  • Immunosuppressants 
  • Steroids 
  • Lenalidomide (Revlimid) 
  • AntiThymocyte Globulin (ATG) 
  • Granulocyte Colony Stimulating Factor (G-CSF) 

Results of first 2 waves conducted are available and another wave of this syndicated tracker is currently in field; new results will be available in the coming weeks. 

Interested in knowing more how to access existing results or subscribe to our syndicated survey, please click here: