# Fractures incidence and its association on mortality in multiple myeloma patients: a nationwide cohort study (CAREMM-2105 study)

## TL;DR

This study shows that multiple myeloma patients have a higher risk of fractures, especially in the hip and spine, which significantly increases their mortality risk.

## Contribution

The study provides new evidence on the strong association between fractures and mortality in multiple myeloma patients using a nationwide cohort.

## Key findings

- MM patients had a significantly higher cumulative incidence of fractures compared to the general population.
- Hip fractures were associated with more than double the mortality risk in MM patients.
- Fractures within the first year of diagnosis were strongly linked to increased mortality across all fracture types.

## Abstract

Multiple myeloma (MM) is known to compromise bone integrity, leading to an increased risk of fractures, which compromise the quality of life and increase mortality rates. This study investigated the incidence of fractures in MM patients and explored the association between fractures after MM diagnosis and mortality using the Korean National Health Insurance Service database. Fracture incidence was compared between MM patients (n = 9365) and 1:1 matched control group from general population. MM patients demonstrated a significantly higher cumulative incidence of fractures, and vertebral and hip fractures presented a particularly elevated hazard ratio (1.36 [95% CI 1.18–1.55] and 1.47 [95% CI 1.10–1.97], respectively). Furthermore, the presence of fracture within the first year of MM diagnosis were associated with increased mortality (any fracture—HR 1.37 [95% CI 1.19–1.58]; vertebral fractures—HR 1.39 [95% CI 1.19–1.63]; hip fractures—HR 2.46 [95% CI 1.52–3.99]; upper limb fractures—HR 1.94 [95% CI 1.32–2.87]). These results showed an increased risk of fracture and a correlation between fractures and increased mortality in MM patients, with hip fractures notably doubling the mortality risk. These findings underscore the importance of monitoring and managing bone health in MM patients to improve survival outcomes.