The Scottish Medicines Consortium (SMC) has decided not to recommend the use of Kyprolis (carfilzomib) and Darzalex (daratumumab) as treatments for myeloma patients in Scotland. Kyprolis was considered in the relapsed and/or refractory setting for patients who have had at least one previous line of treatment in combination Revlimid® (lenalidomide) and dexamethasone but was turned down because the Committee believed that the evidence for overall survival benefits was not strong enough to justify the costs to the NHS. Darzalex was considered for use as a monotherapy in relapsed and refractory patients who have already been treated with Velcade® (bortezomib) and an immunomodulatory drug but there were concerns about the evidence on the benefits of the drug. Amgen is expected to submit an application to the SMC for the approval of Kyprolis and dexamethasone for relapsed and/or refractory myeloma patients in the coming months while Janssen is likely to resubmit Darzalex in combination with other approved anti-myeloma drugs for which there is more robust data.

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