RATIONALE While treatment strategies for multiple myeloma have evolved radically over the last decades, little is known about the risk of fractures for symptomatic multiple myeloma patients over time. OBJECTIVE To determine the effect of different treatment periods (1996-2000, 2001-2006 and 2007-2011) on the risk of fractures in patients with multiple myeloma. METHODS This retrospective case-control study included patients with multiple myeloma in Denmark, using the Danish National Health Service. Cases were defined as patients who had sustained a fracture between 1996 and 2011, and controls were those without a fracture. Exposure was defined as an ICD code for multiple myeloma. Vertebral fractures, gender, and age were considered in secondary analyses. Conditional logistic regression was used to estimate odd ratios (ORs) of fracture risk, and the analyses were adjusted for comorbidities and recent drug use. RESULTS The study population consisted of 925,341 cases, and the same number of matched controls, of whom 1334 patients with multiple myeloma. Among cases, the risk of any fracture was higher in multiple myeloma patients compared to patients without multiple myeloma (any fracture: ORadj[95% CI] 1996-2000: 1.7[1.3-2.3]; 2001-2006: 1.3[1.1-1.6]; 2007-2011: 1.7[1.4-2.2]). Although fractures were mainly non-vertebral, the risk of vertebral fractures in particular was higher in multiple myeloma patients (vertebral fracture: ORadj[95% CI] 1996-2000: 3.5[1.4-8.6]; 2001-2006: 4.0[1.9-8.2]; 2007-2011: 3.0[1.6-5.7]). CONCLUSIONS Despite new treatment strategies and improved supportive care, this study showed no decreased fracture risk for multiple myeloma patients over time. New treatment strategies, even if they have a positive impact on overall survival, offer no guarantee for a corresponding reduction in bone lesions.

中文翻译：

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尽管对多发性骨髓瘤患者进行了 15 年的治疗演变，但骨折风险并未降低：丹麦全国性病例对照研究

基本原理虽然多发性骨髓瘤的治疗策略在过去几十年中发生了根本性的变化，但随着时间的推移，对有症状的多发性骨髓瘤患者骨折的风险知之甚少。目的 确定不同治疗时期（1996-2000、2001-2006 和 2007-2011）对多发性骨髓瘤患者骨折风险的影响。方法 这项回顾性病例对照研究包括丹麦多发性骨髓瘤患者，使用丹麦国家卫生服务机构。病例定义为 1996 年至 2011 年间发生骨折的患者，对照组为未发生骨折的患者。暴露被定义为多发性骨髓瘤的 ICD 代码。在次要分析中考虑了椎骨骨折、性别和年龄。条件逻辑回归用于估计骨折风险的奇数比 (OR)，并根据合并症和近期药物使用情况对分析进行了调整。结果 研究人群包括 925,341 例病例和相同数量的匹配对照，其中 1334 名多发性骨髓瘤患者。在病例中，多发性骨髓瘤患者发生骨折的风险高于非多发性骨髓瘤患者（任何骨折：ORadj[95% CI] 1996-2000：1.7[1.3-2.3]；2001-2006：1.3[1.1-1.6] ]；2007-2011 年：1.7[1.4-2.2])。尽管骨折主要是非椎体，但多发性骨髓瘤患者的椎体骨折风险尤其更高（椎体骨折：ORadj[95% CI] 1996-2000：3.5[1.4-8.6]；2001-2006：4.0[1.9- 8.2]；2007-2011 年：3.0[1.6-5.7]）。结论 尽管有新的治疗策略和改进的支持性护理，该研究表明多发性骨髓瘤患者的骨折风险并没有随着时间的推移而降低。