JMIR Publications

ABSTRACT

Bispecific antibodies are novel immunotherapies approved for the treatment of patients with relapsed/refractory multiple myeloma (MM). While these therapies induce deep and durable responses, they are associated with adverse events (AEs), such as cytokine release syndrome (CRS) and immune effector cell–associated neurotoxicity syndrome (ICANS), that require specific protocols for monitoring, prevention, and treatment. Due to the potential risk of CRS and ICANS, current US labeling recommends inpatient administration during step-up dosing of bispecific antibodies, which typically occurs in academic centers and can often restrict the number of patients that can be treated. The administration of bispecific antibodies in the outpatient and community setting has the ability to enhance the patient experience and reduce resource utilization, which is a barrier to the widespread uptake of these treatments. With bispecific antibodies being evaluated in earlier lines of therapy for MM, broader utilization of these agents will underscore the need for more accessible and less resource-intensive options that ensure safe outpatient administration. This paper offers practical recommendations, built from real-world perspectives and case examples, for institutions seeking to implement remote patient monitoring (RPM) strategies to support the outpatient dosing of bispecific antibodies in patients with MM. The use of RPM has the potential to improve AE detection and management, improve patient outcomes, and decrease resource utilization and costs. While specific approaches will vary based on the needs of each treatment center, RPM implementation can be safe and feasible for both academic and community practices.