The treatment patterns of castration-resistant prostate cancer in Japan, including symptomatic skeletal events and associated treatment and healthcare resource use

Real-world treatment patterns of bone metastatic castration-resistant prostate cancer (mCRPC) in Japan were examined, focusing on treatment patterns and resource use differences attributed to symptomatic skeletal events (SSEs).

Urologists (N = 176) provided retrospective chart data for patients with mCRPC (N = 445) via online surveys. Descriptive analyses and chi-square tests evaluated treatment patterns and their differences by SSE presence; generalized linear mixed models examined healthcare resource utilization differences as a function of SSEs.

Patients were on average 73.6 years old (SD = 8.3), diagnosed with prostate cancer 5.1 years (SD = 6.2), castration-resistant 2.3 years (SD=2.0), and had 7.9 bone metastases sites (SD=12.4). Novel anti-hormones showed increased adoption as mCRPC treatment. Simultaneously, luteinizing hormone-releasing hormone (LHRH) agonist/antagonist use was common (43.6% of patients in 1(st) line), even as CRPC treatment had started. SSEs were uncommon (2-3% per treatment line; 5% at any time), but were associated with increased opioids, strontium-89, bisphosphonates, and NSAIDs use, plus increased healthcare visits (all p < .05).

LHRH agonist/antagonist treatment combinations remain the mCRPC treatment mainstay in Japan. However, novel anti-hormone therapies are becoming well-accepted in practice. SSEs were associated with increased healthcare resource and analgesic use, highlighting the need for efficient symptom management.

Expert review of pharmacoeconomics & outcomes research. 2017 Mar 10 [Epub ahead of print]

Hiroji Uemura, Marco DiBonaventura, Ed Wang, Dianne Athene Ledesma, Kristen Concialdi, Yasuko Aitoku

a Department of Urology and Renal Transplantation , Yokohama City University Medical Center , Yokohama , Japan., b Kantar Health , New York , NY , USA ​​., c US HEOR, Bayer HealthCare , Whippany , NJ , USA., d Market Access, Bayer Yakuhin, Ltd ., Osaka , Japan.