Table 1.
Variable | At NDMM Diagnosis | At IV BP initiation | ||||
---|---|---|---|---|---|---|
Appropriately timed anti‐MM therapya | Untreated with anti‐MM therapy | |||||
N or Median | % or IQR | N or Median | % or IQR | N or Median | % or IQR | |
Total | 348 | 100 | 199 | 100 | 264 | 100 |
Demographics | ||||||
Age, years | ||||||
18‐39 | 7 | 2.0 | 3 | 1.5 | 3 | 1.1 |
40‐49 | 27 | 7.8 | 14 | 7.0 | 17 | 6.4 |
50‐64 | 137 | 39.4 | 76 | 38.2 | 112 | 42.4 |
65+ | 177 | 50.9 | 106 | 53.3 | 132 | 50.0 |
Male sex | 203 | 58.3 | 105 | 52.8 | 151 | 57.2 |
Race | ||||||
White | 230 | 66.1 | 120 | 60.3 | 176 | 66.7 |
Black | 62 | 17.8 | 38 | 19.1 | 44 | 16.7 |
Asian | 2 | 0.6 | 1 | 0.5 | 2 | 0.8 |
Other | 18 | 5.2 | 10 | 5.0 | 11 | 4.2 |
Missing | 36 | 10.3 | 30 | 15.1 | 31 | 11.7 |
Practice type | ||||||
Academic | 22 | 6.3 | 23 | 11.6 | 14 | 5.3 |
Community | 326 | 93.7 | 176 | 88.4 | 250 | 94.7 |
Stage at multiple myeloma diagnosisb | ||||||
Stage I | 56 | 16.1 | 82 | 41.2 | 60 | 22.7 |
Stage II | 105 | 30.2 | 35 | 17.6 | 76 | 28.8 |
Stage III | 82 | 23.6 | 5 | 2.5 | 69 | 26.1 |
Missing | 105 | 30.2 | 77 | 38.7 | 59 | 22.3 |
Insurance payer | ||||||
Commercial health plan | 102 | 29.3 | 56 | 28.1 | 82 | 31.1 |
Medicare | 17 | 4.9 | 10 | 5.0 | 11 | 4.2 |
Multiple | 134 | 38.5 | 76 | 38.2 | 101 | 38.3 |
Other | 27 | 7.8 | 10 | 5.0 | 23 | 8.7 |
Missing | 68 | 19.5 | 47 | 23.6 | 47 | 17.8 |
Comorbiditiesc | ||||||
Diabetes | 133 | 38.2 | 72 | 36.2 | 95 | 36.0 |
Chronic obstructive pulmonary disease and asthma | 140 | 40.2 | 69 | 34.7 | 103 | 39.0 |
Osteoporosis | 78 | 22.4 | 54 | 27.1 | 67 | 25.4 |
Coronary artery disease | 165 | 47.4 | 91 | 45.7 | 116 | 43.9 |
Liver disease | 44 | 12.6 | 25 | 12.6 | 39 | 14.8 |
Renal disease or impairment | 179 | 51.4 | 77 | 38.7 | 107 | 40.5 |
Neuropathy | 170 | 48.9 | 81 | 40.7 | 129 | 48.9 |
Frailty indicatorsc | ||||||
Congestive heart failure | 139 | 39.9 | 64 | 32.2 | 98 | 37.1 |
Decubitus ulcer | 20 | 5.7 | 13 | 6.5 | 20 | 7.6 |
Difficulty walking | 46 | 13.2 | 38 | 19.1 | 46 | 17.4 |
Walker | 29 | 8.3 | 20 | 10.1 | 40 | 15.2 |
Rehabilitation services | 310 | 89.1 | 178 | 89.4 | 238 | 90.2 |
Vertigo | 95 | 27.3 | 48 | 24.1 | 73 | 27.7 |
Other frailty indicatorsd | 27 | 7.8 | 21 | 10.6 | 32 | 12.1 |
History of SREsc | ||||||
Any SRE | 83 | 23.9 | 31 | 15.6 | 97 | 36.7 |
Pathological fracture | 59 | 17.0 | 19 | 9.5 | 71 | 26.9 |
Spinal cord compression | 10 | 2.9 | 1 | 0.5 | 9 | 3.4 |
External beam radiation therapy | 8 | 2.3 | 3 | 1.5 | 20 | 7.6 |
Bone surgery | 36 | 10.3 | 17 | 8.5 | 44 | 16.7 |
Other treatments | ||||||
Immunomodulating agent | 187 | 53.7 | 0 | 0.0 | 134 | 50.8 |
Proteasome inhibitors | 278 | 79.9 | 0 | 0.0 | 196 | 74.2 |
Monoclonal antibodies | 2 | 0.6 | 0 | 0.0 | 1 | 0.4 |
Chemotherapy | 81 | 23.3 | 0 | 0.0 | 61 | 23.1 |
Colony stimulating factor | 7 | 2.0 | 0 | 0.0 | 8 | 3.0 |
Opioids | 161 | 46.3 | 47 | 23.6 | 147 | 55.7 |
Glucocorticoids | 279 | 80.2 | 23 | 11.6 | 200 | 75.8 |
Labs | ||||||
Serum albumin, g/dL | ||||||
Normal: 3.5‐5 g/dL | 140 | 40.2 | 91 | 45.7 | 144 | 54.5 |
Low <3.5 g/dL | 65 | 18.7 | 21 | 10.6 | 84 | 31.8 |
High >5 g/dL | 4 | 1.1 | 4 | 2.0 | 3 | 1.1 |
Serum calcium, mg/dL | ||||||
Normal: 9.1‐10.7 mg/dL | 122 | 35.1 | 90 | 45.2 | 113 | 42.8 |
Hypocalcemia: <9.1 mg/dL | 73 | 21.0 | 26 | 13.1 | 102 | 38.6 |
Hypercalcemia: ≥10.8 mg/dL | 14 | 4.0 | 2 | 1.0 | 19 | 7.2 |
Beta‐2 microglobulin | ||||||
Median (IQR) | 10.8 | (9.7, 12.3) | 12.4 | (10.8, 13.4) | 10.8 | (9.8, 12.0) |
Missing | 118 | 33.9 | 71 | 35.7 | 28 | 10.6 |
eGFR, mL/min | ||||||
<30 | 33 | 9.5 | 8 | 4.0 | 8 | 3.0 |
30 to <60 | 55 | 15.8 | 27 | 13.6 | 50 | 18.9 |
≥60 | 94 | 27.0 | 64 | 32.2 | 146 | 55.3 |
eGFR, estimated glomerular filtration rate; IV BP, intravenous bisphosphonates; MM, multiple myeloma; NDMM, newly diagnosed MM; SRE, skeletal‐related event
Early MM treatment is defined as any MM‐specific therapy within the 30 d before or after NDMM diagnosis.
MM stage was determined directly from the EHR or using values for beta‐2 microglobulin and serum albumin as defined in the International Staging System
Chronic comorbidities and SREs were assessed using all available data prior to the index date.
Other frailty indicators included oxygen use, paralysis, weakness, or wheelchair use.