AT MHM 2015
CHICAGO (FRONTLINE MEDICAL NEWS) – Statin use is associated with a decrease in the prevalence of skeletal-related events in patients with stage I multiple myeloma, findings from a review of 120 cases suggest.
The prevalence of skeletal-related events (SREs) was 35% in 54 patients who had been treated with statins, compared with 56% in 66 statin-naive patients. The difference between the groups remained significant after adjusting for bisphosphonate use, calcium and vitamin D supplementation, history of osteoporosis, and second malignancy, Dr. Fernando Vargas of the University of Miami reported in a poster at the American Society of Hematology Meeting on Hematologic Malignancies.
Study subjects were adults with multiple myeloma seen at a single institution between 2007 and 2012. Those with statin use prior to the development of SREs – defined as pathologic fractures, necessity of orthopedic intervention, radiation therapy, or spinal cord compression – were included. Patients with smoldering myeloma or monoclonal gammopathy of indeterminate significance were excluded.
The statin-experienced and statin-naive groups were similar with respect to smoking history, alcohol abuse, documented diagnosis of osteoporosis, coexistent malignancy, hypothyroidsim, Paget’s disease of the bone, and use of bisphosphonates or calcium plus vitamin D supplementation. The groups also were similar with respect to distribution of cancer staging, and after correcting for International Surgical Staging stage, the SRE risk reduction associated with statin use was significant only in patients with stage I multiple myeloma. One patient with stage I disease (10%) in the statin-experienced group developed SREs, compared with 6 (62%) in the statin-naive group, Dr. Vargas said.
SREs are associated with significant morbidity and mortality in patients with multiple myeloma, and the results of studies assessing the effect of statins on overall disease response in myeloma patients undergoing chemotherapy have been conflicting, he explained, noting that “this analysis was proposed on the grounds that statins inhibit the mevalonic acid pathway upstream from the site of action of bisphosphonates (i.e. famesyl diphosphate synthase blockade), an integral part of multiple myeloma supportive treatment.”
He and his colleagues hypothesized that, given their site of action, statins would have bone protective effects.
Indeed, statins were found to be associated with a decrease in the prevalence of SREs in patients with stage I multiple myeloma, he said.
“Given the well documented safety profile of statins and their ease of use, we suggest that a prospective study be done to further assess their role in the prevention of SREs in multiple myeloma patients,” he concluded, noting that the findings in ISS stage I patients also suggest a possible role for statin use in patients with high-risk smoldering myeloma.
Dr. Vargas reported having no disclosures.
