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Cardiovascular medications and treatment outcomes in multiple myeloma: insights from phase III clinical trials

Ahmad Y Abuhelwa1,2, Sara A Almansour3, Humaid O Al-Shamsi4,5,6,7

  • 1College of Pharmacy, University of Sharjah, Sharjah, UAE. Ahmad.Abuhelwa@sharjah.ac.ae.

Scientific Reports
|February 6, 2026
PubMed

Insights

Patients with multiple myeloma (MM) using ACE inhibitors/ARBs may see improved progression-free survival but face increased adverse events. Other cardiovascular drugs showed no significant impact on MM treatment outcomes.

Area of Science:

  • Cardiology
  • Hematology
  • Oncology

Background:

  • Multiple myeloma (MM) patients have a high risk of cardiovascular diseases.
  • Cardiovascular medications are frequently used by MM patients.
  • Understanding the impact of these medications on MM treatment is crucial.

Purpose of the Study:

  • To investigate the association of baseline cardiovascular drug use with survival and adverse events in MM patients.
  • To analyze data from Phase III trials (CASTOR, MAIA, POLLUX) of daratumumab, lenalidomide, or bortezomib combinations.
  • To assess the impact of specific cardiovascular drug classes on MM treatment outcomes.

Main Methods:

  • Retrospective analysis of Phase III clinical trial data.
  • Cox proportional hazard analysis for survival outcomes.
  • Logistic regression for adverse events (grade ≥3).
  • Focus on beta-blockers, calcium channel blockers, ACE inhibitors (ACEI), angiotensin II receptor blockers (ARBs), diuretics, and statins.

Main Results:

  • Among 1804 patients, ACEI/ARBs were most common (31%).
  • ACEI/ARBs use was linked to better progression-free survival (aHR=0.84) but higher odds of grade ≥3 adverse events (aOR=1.45).
  • Diuretic use was also associated with increased odds of grade ≥3 adverse events (aOR=1.53).
  • Other cardiovascular drugs showed no significant associations with MM outcomes.

Conclusions:

  • ACE inhibitors/ARBs may offer a progression-free survival benefit in MM patients but warrant caution due to increased safety concerns.
  • Diuretics are also associated with a higher risk of severe adverse events.
  • Baseline use of other common cardiovascular medications does not appear to significantly affect MM treatment outcomes.
  • Further research is needed to clarify the complex interplay between cardiovascular drugs and MM treatment.

Keywords:
Adverse eventsCardiovascular drugsMultiple myelomaOverall survivalProgression-free survivalTreatment outcomes

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