title: The treatment patterns of castration-resistant prostate cancer in Japan, including symptomatic skeletal events and associated treatment and healthcare resource use.
abstract: BACKGROUND
  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).
  
  
  METHODS
  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.
  
  
  RESULTS
  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 1stline), 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: a Department of Urology and Renal Transplantation , Yokohama City University Medical Center , Yokohama , Japan.
authors.forename: Hiroji
authors.initials: H
authors.lastname: Uemura
authors.affiliation: b Kantar Health , New York , NY , USA ​​.
authors.forename: Marco
authors.initials: M
authors.lastname: DiBonaventura
authors.affiliation: c US HEOR, Bayer HealthCare , Whippany , NJ , USA.
authors.forename: Ed
authors.initials: E
authors.lastname: Wang
authors.affiliation: d Market Access, Bayer Yakuhin, Ltd ., Osaka , Japan.
authors.forename: Dianne Athene
authors.initials: DA
authors.lastname: Ledesma
authors.affiliation: b Kantar Health , New York , NY , USA ​​.
authors.forename: Kristen
authors.initials: K
authors.lastname: Concialdi
authors.affiliation: d Market Access, Bayer Yakuhin, Ltd ., Osaka , Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Aitoku
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000037:antagonists & inhibitors; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D016014:Linear Models; D008297:Male; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies
chemical_list: D018931:Antineoplastic Agents, Hormonal; D007987:Gonadotropin-Releasing Hormone
keywords: Healthcare resource use; metastatic castration-resistant prostate cancer; pain management; symptomatic skeletal events; treatment; treatment patterns