Bortezomib Linked to Falls in Older Adults with Multiple Myeloma

A recent study has established an association between bortezomib and risk for a diagnostic code for falls among older adults with multiple myeloma (MM).

“Falls in particular are a significant cause of morbidity and mortality in older adults and are more common in older adults with cancer than in matched controls,” study researchers wrote. “Older adults with cancer who experience falls are at greater risk for injuries or death after a hospitalization for fall-related injuries.”

This study was designed to assess the relationship between bortezomib, which can cause treatment-related peripheral neuropathy, and falls in older patients with MM.

The researchers looked at data from older adults with newly diagnosed MM from the SEER-Medicare database from 2007 to 2013; 2,052 were using first-line bortezomib.

“Nearly 1-in-10 older adults treated with bortezomib in the first-line setting had a diagnostic code for falls within the first 12 months of treatment,” the researchers wrote.

Claims for falls were reported in 8% of patients within 12 months of starting bortezomib compared with 5% of patients who were not receiving bortezomib (P<.001). After controlling for covariates, bortezomib was associated with a 36% increased risk for falls (adjusted hazard ratio=1.36; 95% CI, 1.05-1.75; P=.018).

There was a significant difference in overall survival between those patients who survived 12 months after starting treatment and did or did not experience a fall (median overall survival was 35.7 vs. 49.1 months; P<.0001). A fall in the first year after diagnosis was associated with a 26% increased risk in hazard for death (aHR=1.26; 95% CI, 1.02-1.56; P=.033). According to the researchers, this finding “underscores the importance of fall prediction and risk mitigation in this patient population.”

“The reasons why older adults treated with bortezomib fall should be elucidated in future prospective research,” the researchers wrote. “Consideration should be given to incorporate fall assessments into standard clinical practice for older adults with multiple myeloma treated with bortezomib.”