Patient-reported Outcomes for Multicentric Castleman’s Disease in a Randomized, Placebo-controlled Study of Siltuximab

Frits van Rhee, Margaret Rothman, Kai Fai Ho, Sarah Fleming, Raymond S. Wong, Alexander Fosså, Angela Dispenzieri, James Cavet, Nikhil Munshi, Jessica Vermeulen, Corey Casper

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Multicentric Castleman’s disease (MCD) is a rare lymphoproliferative disorder driven by dysregulated interleukin-6 production. MCD has a poor prognosis, and treatment is generally noncurative and aimed at symptom relief. Siltuximab is a novel, monoclonal interleukin-6 antibody recently shown to be effective in a registration clinical trial. MCD symptoms, such as fatigue, pain, and weakness, are most appropriately quantified using patient-reported outcome (PRO) measures. We assessed the effect of siltuximab on patient perception of symptoms, functional status, and wellbeing using PRO instruments. Methods: We analyzed results of a randomized, double-blind trial comparing siltuximab 11 mg/kg every 3 weeks with placebo to treat MCD. Subjects (N = 79) completed the recently developed MCD–Symptom Scale (MCD–SS), the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT–Fatigue) scale, and the Short Form (SF)-36 at predetermined time points throughout the treatment period. Scores were compared at baseline and over time between the treatment arms and PRO instruments. Results: At baseline, the mean number of symptoms reported was 9.2 (standard deviation 3.76) out of 16 total, as measured by the MCD–SS. Fatigue was a key symptom across all PRO instruments. Siltuximab-treated subjects reported early improvements in symptoms compared with subjects in the placebo arm on both the MCD–SS and FACIT–Fatigue scale. Statistically significant improvements in five SF-36 domains were observed in siltuximab-treated patients, namely role physical, role emotional, vitality, bodily pain, and mental health. Conclusions: Patients with MCD commonly report impairments in functioning, wellbeing, and fatigue at baseline. Siltuximab-treated patients reported significant improvements in these outcomes after treatment.

Original languageEnglish (US)
Pages (from-to)207-216
Number of pages10
JournalPatient
Volume8
Issue number2
DOIs
StatePublished - Apr 1 2015

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Placebos
Fatigue
Interleukin-6
Chronic Disease
Pain
Lymphoproliferative Disorders
Patient Reported Outcome Measures
Multi-centric Castleman's Disease
siltuximab
Mental Health
Therapeutics
Clinical Trials
Antibodies

ASJC Scopus subject areas

  • Nursing (miscellaneous)

Cite this

van Rhee, F., Rothman, M., Ho, K. F., Fleming, S., Wong, R. S., Fosså, A., ... Casper, C. (2015). Patient-reported Outcomes for Multicentric Castleman’s Disease in a Randomized, Placebo-controlled Study of Siltuximab. Patient, 8(2), 207-216. https://doi.org/10.1007/s40271-015-0120-5

Patient-reported Outcomes for Multicentric Castleman’s Disease in a Randomized, Placebo-controlled Study of Siltuximab. / van Rhee, Frits; Rothman, Margaret; Ho, Kai Fai; Fleming, Sarah; Wong, Raymond S.; Fosså, Alexander; Dispenzieri, Angela; Cavet, James; Munshi, Nikhil; Vermeulen, Jessica; Casper, Corey.

In: Patient, Vol. 8, No. 2, 01.04.2015, p. 207-216.

Research output: Contribution to journalArticle

van Rhee, F, Rothman, M, Ho, KF, Fleming, S, Wong, RS, Fosså, A, Dispenzieri, A, Cavet, J, Munshi, N, Vermeulen, J & Casper, C 2015, 'Patient-reported Outcomes for Multicentric Castleman’s Disease in a Randomized, Placebo-controlled Study of Siltuximab', Patient, vol. 8, no. 2, pp. 207-216. https://doi.org/10.1007/s40271-015-0120-5
van Rhee, Frits ; Rothman, Margaret ; Ho, Kai Fai ; Fleming, Sarah ; Wong, Raymond S. ; Fosså, Alexander ; Dispenzieri, Angela ; Cavet, James ; Munshi, Nikhil ; Vermeulen, Jessica ; Casper, Corey. / Patient-reported Outcomes for Multicentric Castleman’s Disease in a Randomized, Placebo-controlled Study of Siltuximab. In: Patient. 2015 ; Vol. 8, No. 2. pp. 207-216.
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T1 - Patient-reported Outcomes for Multicentric Castleman’s Disease in a Randomized, Placebo-controlled Study of Siltuximab

AU - van Rhee, Frits

AU - Rothman, Margaret

AU - Ho, Kai Fai

AU - Fleming, Sarah

AU - Wong, Raymond S.

AU - Fosså, Alexander

AU - Dispenzieri, Angela

AU - Cavet, James

AU - Munshi, Nikhil

AU - Vermeulen, Jessica

AU - Casper, Corey

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N2 - Background: Multicentric Castleman’s disease (MCD) is a rare lymphoproliferative disorder driven by dysregulated interleukin-6 production. MCD has a poor prognosis, and treatment is generally noncurative and aimed at symptom relief. Siltuximab is a novel, monoclonal interleukin-6 antibody recently shown to be effective in a registration clinical trial. MCD symptoms, such as fatigue, pain, and weakness, are most appropriately quantified using patient-reported outcome (PRO) measures. We assessed the effect of siltuximab on patient perception of symptoms, functional status, and wellbeing using PRO instruments. Methods: We analyzed results of a randomized, double-blind trial comparing siltuximab 11 mg/kg every 3 weeks with placebo to treat MCD. Subjects (N = 79) completed the recently developed MCD–Symptom Scale (MCD–SS), the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT–Fatigue) scale, and the Short Form (SF)-36 at predetermined time points throughout the treatment period. Scores were compared at baseline and over time between the treatment arms and PRO instruments. Results: At baseline, the mean number of symptoms reported was 9.2 (standard deviation 3.76) out of 16 total, as measured by the MCD–SS. Fatigue was a key symptom across all PRO instruments. Siltuximab-treated subjects reported early improvements in symptoms compared with subjects in the placebo arm on both the MCD–SS and FACIT–Fatigue scale. Statistically significant improvements in five SF-36 domains were observed in siltuximab-treated patients, namely role physical, role emotional, vitality, bodily pain, and mental health. Conclusions: Patients with MCD commonly report impairments in functioning, wellbeing, and fatigue at baseline. Siltuximab-treated patients reported significant improvements in these outcomes after treatment.

AB - Background: Multicentric Castleman’s disease (MCD) is a rare lymphoproliferative disorder driven by dysregulated interleukin-6 production. MCD has a poor prognosis, and treatment is generally noncurative and aimed at symptom relief. Siltuximab is a novel, monoclonal interleukin-6 antibody recently shown to be effective in a registration clinical trial. MCD symptoms, such as fatigue, pain, and weakness, are most appropriately quantified using patient-reported outcome (PRO) measures. We assessed the effect of siltuximab on patient perception of symptoms, functional status, and wellbeing using PRO instruments. Methods: We analyzed results of a randomized, double-blind trial comparing siltuximab 11 mg/kg every 3 weeks with placebo to treat MCD. Subjects (N = 79) completed the recently developed MCD–Symptom Scale (MCD–SS), the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT–Fatigue) scale, and the Short Form (SF)-36 at predetermined time points throughout the treatment period. Scores were compared at baseline and over time between the treatment arms and PRO instruments. Results: At baseline, the mean number of symptoms reported was 9.2 (standard deviation 3.76) out of 16 total, as measured by the MCD–SS. Fatigue was a key symptom across all PRO instruments. Siltuximab-treated subjects reported early improvements in symptoms compared with subjects in the placebo arm on both the MCD–SS and FACIT–Fatigue scale. Statistically significant improvements in five SF-36 domains were observed in siltuximab-treated patients, namely role physical, role emotional, vitality, bodily pain, and mental health. Conclusions: Patients with MCD commonly report impairments in functioning, wellbeing, and fatigue at baseline. Siltuximab-treated patients reported significant improvements in these outcomes after treatment.

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