Study Finds Statin Use Associated With Reduced Mortality in Multiple Myeloma
Analysis of data from the Veterans Administration Central Cancer Registry, reported in the Journal of Clinical Oncology by Sanfilippo et al, showed that statin use was associated with a reduced risk of all-cause and multiple myeloma–specific mortality in patients with multiple myeloma. Statins are active in a pathway affected by nitrogen-containing bisphosphonates, which have been associated with improved survival in multiple myeloma.
Study Details
The study involved 4,957 patients in the registry diagnosed with multiple myeloma between 1999 and 2013; of them, 2,294 received statins, with statin use defined as any prescription for a statin within 3 months before or any time after multiple myeloma diagnosis. Median follow-up for statin users and nonusers was 34 months and 26 months, respectively. A multiple myeloma–specific mortality cohort included 3,284 patients, with 1,415 being statin users. Median follow-up for statin users and nonusers in this cohort was 38 months and 24 months, respectively. Analysis was adjusted for baseline multiple myeloma prognostic factors, body mass index, age, race, Charlson comorbidity index, year of diagnosis, hemoglobin level, creatinine clearance, albumin level, and multiple myeloma treatment.
Effect on Survival
Median overall survival was 39.5 months among statin users vs 27 months in nonusers. In adjusted analyses, the adjusted hazard ratio (HR) for all-cause mortality was 0.79 (P < .001), and the adjusted hazard ratio for multiple myeloma–specific mortality was 0.76 (P < .001). Statin use was also associated with a reduced risk of skeletal-related events (adjusted HR = 0.69, P < .001).
In daily defined dose sensitivity analysis, adjusted hazard ratios were 0.80 (P < .001) for < 365 daily defined doses and 0.78 (P < .001) for ≥ 365 daily defined doses for all-cause mortality and 0.78 (P = .001) for < 365 daily defined doses and 0.72 (P < .001) for ≥ 365 daily defined doses for multiple myeloma–specific mortality. A 12-month landmark sensitivity analysis included patients surviving ≥ 12 months from multiple myeloma diagnosis, with statin users defined as those who were on statin therapy at multiple myeloma diagnosis or who started statins within 12 months of multiple myeloma diagnosis. In this analysis, statin use remained associated with a significantly reduced risk of all-cause mortality (adjusted HR = 0.86, P = .001) and multiple myeloma–specific mortality (adjusted HR = 0.83, P = .01).
The investigators concluded: “In this cohort study of US veterans with [multiple myeloma], statin therapy was associated with a reduced risk of both all-cause and [multiple myeloma]-specific mortality. Our findings suggest a potential role for statin therapy in patients with [multiple myeloma]. The putative benefit of statin therapy in [multiple myeloma] should be corroborated in prospective studies.”
The study was supported by the National Institutes of Health, the National Heart, Lung, and Blood Institute, Barnes Jewish Foundation, and American Cancer Society.
Kristen Marie Sanfilippo, MD, MPHS, of Washington University School of Medicine, is the corresponding author of the Journal of Clinical Oncology article.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
