Related Experiment Video
Updated: Jan 28, 2026
Establishment of a Human Multiple Myeloma Xenograft Model in the Chicken to Study Tumor Growth, Invasion and Angiogenesis
Published on: May 1, 2015
Incidence of first and subsequent fractures in multiple myeloma patients: a parallel cohort study using UK CPRD
Rohit Vijjhalwar1, Kaiyang Song2, Franz Clemeno3
1University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Abstract:
Based on a UK primary care dataset, patients with Multiple Myeloma (MM) experience a significantly higher index fracture rate from 1 year prior to MM diagnosis onwards and a higher subsequent vertebral fracture rate, compared to non-MM controls. There is potential for earlier MM diagnosis and reducing subsequent fracture risk.
Purpose:
Whilst multiple myeloma (MM) is known to increase fracture risk, the incidence of subsequent fractures is poorly described. Here, we describe the incidence of index and subsequent fractures in a real-world cohort of MM patients, compared to non-MM controls.
Methods:
Using the UK Clinical Practice Research Datalink GOLD, we identified a MM cohort with age-, sex-, and GP-practice-matched controls from 1995 to 2017. The primary outcome was the incidence of fracture at major osteoporotic sites (i.e. hip, vertebral, wrist, or humerus) within 2 years before and after MM diagnosis. The cumulative incidence of subsequent fractures up to 2 years post-index fracture was estimated using Cox proportional hazards models.
Results:
A total of 1972 patients (54.7% male, median age 70 years) with MM were matched to 6413 non-MM controls. The index fracture rate was significantly greater in the MM cohort compared to the non-MM cohort from 1 year prior to MM diagnosis onwards. Post-index fracture, the overall 2-year subsequent major fracture rate was 14.7% (95% CI:11.4-20.5) and 14.6% (95% CI:10.8-19.2) in the MM and non-MM cohorts, respectively. Within 2 years post-index fracture, the risk of subsequent vertebral fracture was significantly greater in MM patients (aHR: 8.16 (95% CI: 1.84-36.1), p = 0.006).
Conclusions:
MM patients are at higher risk of having an index fracture from 1 year pre-diagnosis and a subsequent vertebral fracture in the 2 years post-index fracture, compared to non-MM controls. These findings highlight the potential for earlier MM diagnosis in adults presenting with a major fracture, and the need to reduce subsequent fracture risk.
Insights
Multiple Myeloma (MM) patients have a higher risk of fractures before diagnosis and increased subsequent vertebral fractures post-diagnosis. Early MM detection and fracture risk reduction are crucial.
Area of Science:
- Orthopedics
- Hematology
- Epidemiology
Background:
- Multiple Myeloma (MM) is known to elevate fracture risk.
- The incidence and characteristics of subsequent fractures in MM patients require further elucidation.
Purpose of the Study:
- To quantify the incidence of index and subsequent fractures in a real-world cohort of MM patients.
- To compare fracture incidence in MM patients against matched non-MM controls.
Main Methods:
- Utilized the UK Clinical Practice Research Datalink GOLD (1995-2017).
- Identified MM cohort and age-, sex-, GP-practice-matched controls.
- Analyzed fractures at major osteoporotic sites within 2 years pre/post-MM diagnosis, estimating cumulative incidence of subsequent fractures using Cox models.
Main Results:
- MM patients showed a significantly higher index fracture rate starting 1 year before diagnosis compared to controls.
- The 2-year subsequent major fracture rate was similar (14.7% MM vs. 14.6% non-MM).
- MM patients had a significantly higher risk of subsequent vertebral fractures within 2 years post-index fracture (aHR: 8.16).
Conclusions:
- Multiple Myeloma patients face elevated index fracture risk pre-diagnosis and increased subsequent vertebral fracture risk post-diagnosis.
- Findings suggest potential for earlier MM diagnosis in adults presenting with major fractures.
- There is a critical need to implement strategies for reducing subsequent fracture risk in MM patients.
Related Concept Videos
01:08Prevalence and Incidence
Prevalence indicates the proportion of individuals in a population who have a specific disease or health...
01:23Parallel Resonance
01:20Parallel Processing
01:11Bioavailability Study Design: Single Versus Multiple Dose Studies
01:21Types of Reports II: Incident or Occurrence Report
Purposes:
In the healthcare industry, reports play a crucial role in documenting incidents within an agency. The primary objective of these reports is to ensure patient safety, uphold the...
01:23Resistors In Parallel