Does teclistamab cause infections in patients with relapsed/refractory multiple myeloma based on real-world data?
Teclistamab is a bispecific antibody used to treat relapsed/refractory multiple myeloma. It works by redirecting immune cells to attack myeloma cells, but this can also increase the risk of infections. Real-world data from patients treated outside of clinical trials helps give a clearer picture of how often infections actually happen in everyday practice.
What the research says
A meta-analysis that combined data from 5 studies with 714 patients found that infections are common with teclistamab. Overall, about 56.5% of patients had any infection, and 27.6% had a severe (grade ≥3) infection 5. However, when looking specifically at real-world evidence (RWE), the infection rates were lower: 45.4% for any infection and 22.8% for severe infections 5. In comparison, the pivotal clinical trial (MajesTEC-1) reported higher rates of 76.4% and 44.8%, respectively 5. This difference may be due to stricter monitoring and reporting in trials, or differences in patient health.
Another real-world study from a single center that included 101 patients treated with BCMA-directed bispecific antibodies (including teclistamab) found that the cumulative risk of a first infection at 5 months was 38.6%, and at 10 months was 47.9% 11. This study also showed that giving intravenous immunoglobulin (IVIG) as a preventive measure significantly reduced the risk of severe infections 11.
In the MajesTEC-1 trial, infections occurred in 70% of patients who had previously received BCMA-targeted therapy, with severe infections in 32.5% 9. Most infections were viral, especially upper respiratory infections 11. Cytomegalovirus (CMV) infections were also common, with a cumulative incidence of about 45% at 5 months 11.
What to ask your doctor
- What is my personal risk of infection with teclistamab based on my health history?
- Should I receive preventive treatments like IVIG or antiviral medications to lower infection risk?
- How will my blood counts and infection signs be monitored during treatment?
- What symptoms of infection should I watch for and when should I contact you?
- Are there any vaccines I should get before starting teclistamab?
This question is drawn from common patient questions about this topic and answered using cited medical research. We do not provide individualized advice.