Abstract 14693: Venous Thromboembolism in the Modern Era of Multiple Myeloma : An Analysis of Real-World Data From a Nationwide Claims Database in Japan

Abstract

Introduction: Treatment for Multiple Myeloma (MM) with new therapeutic agents has dramatically improved outcomes and increased the number of survivors. Although venous thromboembolism (VTE) is common in MM, the pathophysiological interplay between VTE and MM, including risk factors related to the patient, disease, and modern treatments, is complex and incompletely understood. Objectives: To evaluate real-world data on the risk factors of VTE and outcomes of patients with MM using a nationwide claims database. Methods: This study involved the retrospective observational analysis of the Japan Medical Data Center (JMDC, Tokyo, Japan) database, an anonymized patient-level claims database younger than 75 years old. We identified cases with diagnosis and treatment of MM with codes provided by JMDC. Patients with a tentative diagnosis code of MM [C90] were included. Cases with a history of VTE or a pre-diagnostic history of fewer than six months were excluded. Propensity score (PS) was calculated using logistic regression based on age, gender, and cardiovascular risk factors. Results: We identified 2,023 eligible cases (mean age 53.6 ± 11.8 years) between January 2015 and December 2020. After 1:1 PS matching, the number of patients, mean age (years), follow-up (months) were as follows: MM group (n=280, 58.7 ± 8.1, 18.6 ± 14.8), Control group (n=280, 58.5 ± 8.1, 24.4 ± 18.4). Kaplan-Meier analysis indicated that the rate of VTE within 60 months was significantly higher among MM than in Control (25.7% vs 2.5%, Log-rank p<.001). Within the MM group, multivariable Cox proportional hazard model showed that lenalidomide had a risk of VTE (Hazard Ratio 1.16 [95% Confidence Interval: 1.19-7.69]) among modern therapies (stem cell transplantation 37.1%, elotuzumab 6.4%, daratumumab 16.8%, bortezomib 88.9%, carfilzomib 21.8%, ixazomib 11.8%, thalidomide 3.9%, lenalidomide 78.9%, and pomalidomide 15.4%). Conclusions: Patients who underwent modern MM therapies, including immunomodulatory agents, had significantly higher VTE risk than PS-matched Control. Therefore, further studies using real-world data to improve prevention, early detection, and treatment of MM-related VTE are warranted.