Incidence and risk factors of skeletal-related events in patients with multiple myeloma: A population-based study of Korea

Abstract

Abstract Multiple myeloma (MM) patients are at risk of skeletal-related events (SREs) like spinal cord compression, pathologic fractures, bone surgery, and radiation to bone. Given the lack of real-world data on SREs in MM, we conducted a large, retrospective, nationwide cohort study from 2007 to 2018. 43.9% of 6,717 patients had SREs at baseline. After a median follow-up of 35.1 months, 43.6% of patients had SREs, and 39.6% had four or more. 9.6 months was the median SRE time (interquartile range [IQR], 1.2–25.8). The median time to first SRE was 3.0 months for patients with a history of SRE and 19.8 months for those without. During follow-up, 78.5% of patients received bone-targeting agents (BTAs). On multiple logistic regression analysis, females aged 50 years or older versus males under 50 years old (odds ratio [OR], 1.54), cerebrovascular disease (OR, 1.33), first-line chemotherapy regimen without bortezomib or lenalidomide (OR 1.50), and history of prior SREs with BTA use versus no history of SREs without BTA use (OR 5.79) were associated with SRE risk. This population-based study is the first to report the incidence and risk factors of SREs in Korean MM patients, which can be used to assess their bone health.