Patients with multiple myeloma may not be receiving optimal therapy for bone disease, according to a study published in Supportive Care in Cancer (online: March 7, 2018; doi: 10.1007/s00520-018-4133-1).
This finding may particularly apply to patients with renal impairment, according to researchers.
Current guidelines recommend intravenous bisphosphonates to be initiated in all patients with multiple myeloma for the management of bone disease.
In the retrospective observational study, Christopher Kim, MPH, PhD, Amgen, and colleagues used Amgen’s Oncology Services Comprehensive Electronic Records (OSCER) database to collect oncology health record data on a total of 11,112 patients who were newly diagnosed with multiple myeloma between January 1, 2009 and April 30, 2016.
Researchers calculated timing of bisphosphonate administration, frequency, schedule, changes in dosing schedule, and discontinuations. Additionally, researchers assessed bisphosphonate treatment relative to renal function and anti-multiple myeloma therapy regimens. Secondary outcomes included identifying predictors of bisphosphonate treatment initiation and to further analyze data once patients were stratified by chronic kidney disease stage.
Researchers noted that after a follow up of 687 days, 63% of patients received at least one bisphosphonate administration, primarily every 4 weeks. Mean time from diagnosis to bisphosphonate administration was 106 days. About 58% of patients initiated treatment within the first year after diagnosis and about 50% either discontinued or changed dosing.
Additionally, researchers reported that patients with poorer renal function by estimated glomerular filtration rate stage at baseline were less likely to receive bisphosphonates and more likely to have delayed initiation of bisphosphonate treatment from diagnosis.
