Regular Aspirin Use and Mortality in Multiple Myeloma Patients

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Cancer Epidemiol Biomarkers Prev. 2021 Dec 3:cebp.EPI-21-0946-E.2021. doi: 10.1158/1055-9965.EPI-21-0946. Online ahead of print.

ABSTRACT

BACKGROUND: Inflammation is important in multiple myeloma (MM) pathogenesis, and regular aspirin use has been shown to confer a reduced risk of MM. The influence of aspirin on survival after MM diagnosis is unknown.

METHODS: We identified 436 men and women diagnosed with MM between 1980 and 2016 in the Health Professionals Follow-up Study (HPFS) and the Nurses’ Health Study (NHS) who reported aspirin intake biennially on follow-up questionnaires. Using multivariable Cox proportional hazards regression models, we estimated hazard ratios (HR) and 95% confidence intervals (CI) associated with aspirin use on MM-specific and overall mortality.

RESULTS: Compared with nonusers, participants who used aspirin after diagnosis had a multivariable HR for MM-specific mortality of 0·61 (95% confidence interval [CI], 0·46, 0·79) and for overall mortality of 0·63 (95% CI, 0·49, 0·80), after adjustment for age at diagnosis, year of diagnosis, sex, body mass index, pre-diagnosis aspirin use, and number of comorbidities. For post-diagnosis aspirin quantity, we observed a modest trend of reduction in MM-specific and all-cause mortality with increasing number of 325 mg tablets of aspirin per week, although the confidence intervals for 1 to <6 and {greater than or equal to}6 tablets overlapped. Results were not materially different before or after the availability of novel therapies (before vs. after the year 2000). Pre-diagnosis frequency or duration of aspirin use was not significantly associated with MM-specific or overall mortality.

CONCLUSIONS: Findings support the use of aspirin as a complementary strategy to enhance MM survival.

IMPACT: Confirmation in samples that have comprehensive clinical information is encouraged.

PMID:34862208 | DOI:10.1158/1055-9965.EPI-21-0946