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Summary <p>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.</p> Purpose <p>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.</p> Methods <p>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.</p> Results <p>A total of 1972&#xa0;patients (54.7% male, median age 70&#xa0;years) with MM were matched to 6413&#xa0;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:&#xa0;1.84-36.1), <i>p</i> = 0.006). </p> Conclusions <p>MM patients are at higher risk of having an index fracture from 1 year pre-diagnosis and&#xa0;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.</p>

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Incidence of first and subsequent fractures in multiple myeloma patients: a parallel cohort study using UK CPRD dataset

  • 期刊论文

  • 发表日期：

    2026年1月26日

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  • Rohit Vijjhalwar,
  • Kaiyang Song,
  • Franz Clemeno,
  • Maria T. Sanchez-Santos,
  • Samuel Hawley,
  • Bhuvan Kishore,
  • Kwee Yong,
  • Stella Bowcock,
  • Karthik Ramasamy,
  • Antonella Delmestri,
  • Rafael Pinedo-Villanueva,
  • Muhammad Kassim Javaid

摘要

Summary

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.