Incidence and prevention of skeletal-related events in multiple myeloma patients: A population-based real-world
Marie Røra1,2, Margrete Skretting Solberg1,2, Kari Lenita Falck Moore3,4,5
1Department of Clinical and Molecular Medicine Norwegian University of Science and Technology (NTNU) Trondheim Norway.
Abstract:
Novel treatments in multiple myeloma (MM) could influence the incidence of skeletal-related events (SREs). We aimed to examine the incidence of SRE and the preventive use of osteoclast inhibitors (OIs) in a cohort of MM patients in the era of modern treatment. In this real-world retrospective study, we included 199 patients with a diagnosis of MM between January 1, 2010, and December 31, 2019, with follow-up at St. Olavs University Hospital. Data was extracted from The Myeloma Registry of Central Norway. SREs occurred in 46% of patients at baseline and 55.8% during follow-up. Excluding baseline SREs, the incidence rate was 29 (95% confidence interval: 26-33) per 100 person years. 48% experienced > 1 SRE. The incidence of SREs was highest at baseline followed by a gradual increase in each subsequent line of treatment. The first two years after diagnosis 80% received bisphosphonates (BPs). The proportion of recommended dosage was 46%. Only two cases (1.2%) of symptomatic hypocalcemia and one case (0.6%) of osteonecrosis of the jaw were identified. SREs are still a common problem in an era of novel treatment. Cumulative dosage of BPs was lower than recommended, and treatment with BPs was safe in this population.
Insights
Skeletal-related events (SREs) remain common in multiple myeloma (MM) patients despite novel treatments. Osteoclast inhibitors (OIs) like bisphosphonates (BPs) were used, but at suboptimal doses, though generally safe.
Area of Science:
- Oncology
- Hematology
- Bone Metabolism
Background:
- Novel treatments for multiple myeloma (MM) may impact skeletal-related events (SREs).
- Understanding SRE incidence and osteoclast inhibitor (OI) use is crucial in modern MM treatment eras.
Purpose of the Study:
- To investigate SRE incidence and OI utilization in MM patients receiving contemporary therapies.
- To assess the safety and dosage patterns of bisphosphonates (BPs) in this cohort.
Main Methods:
- Real-world retrospective study of 199 MM patients diagnosed between 2010-2019.
- Data sourced from The Myeloma Registry of Central Norway.
- Analysis of SRE occurrence, OI use, dosage, and adverse events during follow-up.
Main Results:
- SREs affected 46% at baseline and 55.8% during follow-up; incidence rate was 29 per 100 person-years (excluding baseline).
- 48% experienced more than one SRE, with incidence rising with treatment lines.
- 80% received bisphosphonates (BPs) within two years, but only 46% received the recommended dosage; BP treatment was safe.
Conclusions:
- SREs continue to be a significant issue for multiple myeloma patients, even with advanced treatments.
- Suboptimal cumulative dosage of bisphosphonates (BPs) was observed, yet BP therapy demonstrated a favorable safety profile.
- Further research into optimizing OI dosing is warranted to improve SRE management in MM.
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