Real-World Treatment Patterns of Elranatamab in Patients with Multiple Myeloma in Japan: The EVEREST Study

Elranatamab, a B-cell maturation antigen-CD3 bispecific antibody, was approved in Japan in March 2024 for the treatment of relapsed or refractory multiple myeloma (MM). However, real-world (RW) data on its use remain limited. This retrospective study evaluated patient characteristics and elranatamab treatment patterns in patients with MM in Japan using the Medical Data Vision (MDV) database.

This EVEREST study used de-identified claims data from the MDV database for adult patients with MM who initiated treatment with elranatamab between March 26, 2024, and March 31, 2025. Follow-up was divided, based on expected dosing schedules, into a step-up dosing (SUD) period, a weekly (QW) maintenance period (MP1), an every 2 weeks (Q2W) maintenance period (MP2), and an overall follow-up period. Treatment patterns were reported descriptively. Estimated annual vial usage was extrapolated.

Patients (N=253) with a median age of 74 years (range 41-93 years) and median treatment duration of 60.0 days (interquartile range [IQR], 26.0-136.0) were included. The mean (median [IQR]) time between elranatamab administrations across dosing periods were SUD 4.0 days (4.0 [3-4]), MP1 9.8 days (7.0 [7-9]), and MP2 13.0 days (14.0 [7-14]), indicating less frequent dosing than recommended in MP1, and comparable dosing in MP2. Nearly all administrations were in inpatient settings during SUD, and most were in outpatient settings during maintenance periods. Despite variable dosing during the maintenance periods, annual elranatamab usage was lower than the approved label recommendations for Japan (34.4 vs 39.0 vials per year).

Early RW data on elranatamab administration and vial usage in patients with MM in Japan suggest that dosing is generally aligned with label expectations, with variable dosing during QW and Q2W maintenance for some patients. Projected vial usage in this RW setting was lower than the expected usage per label.