Though carfilzomib increases the risk of heart failure in patients with multiple myeloma (MM), the risk does not appear to vary between Black and White patients, according to study results published in Clinical Lymphoma, Myeloma & Leukemia.
In this retrospective study, researchers analyzed adults who were diagnosed with MM between 2013 and 2019, had received at least 1 line of MM treatment, and were enrolled in 1 of 3 databases.
There were 19,440 patients from the Medicare Fee-for-Service (FFS) database, 5820 from Optum Clinformatics Data Mart, and 3786 from the Humana Research Database. The total number of patient episodes available for analysis were 34,297 for the Medicare FFS cohort, 11,730 for the Optum cohort, and 6421 for the Humana cohort.
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Incidence rates of heart failure hospitalization in carfilzomib-treated and non-carfilzomib-treated patients differed in each cohort.
In the Medicare FFS cohort, incidence rates of heart failure hospitalization were higher in patients treated with a carfilzomib-based regimen than in those who did not receive carfilzomib for both Black patients (15.8 vs 12.1 events per 100 person-years) and White patients (14.5 vs 10.7 events per 100 person-years).
In the Optum cohort, incidence rates of heart failure hospitalization were lower in patients treated with carfilzomib than in those who did not receive carfilzomib for both Black patients (8.9 vs 11.5 events per 100 person-years) and White patients (7.3 vs 8.4 events per 100 person-years). However, these differences were not significant.
In the Humana cohort, incidence rates of heart failure hospitalization were somewhat higher in patients treated with carfilzomib than in those who did not receive carfilzomib for White patients (8.7 vs 8.1 events per 100 person-years) but slightly lower for Black patients (9.9 vs 11.2 events per 100 person-years). Again, these differences were not significant.
Using propensity score matching, the researchers determined that, in the Medicare FFS cohort, treatment with carfilzomib was associated with a 60% higher risk of heart failure hospitalization among White patients (hazard ratio [HR], 1.6; 95% CI, 1.3-2.0) and a 70% higher risk among Black patients (HR, 1.7; 95% CI, 1.0-2.9).
In the Humana cohort, differences in the risk of heart failure hospitalization between carfilzomib- and non-carfilzomib-treated patients were insignificant for both Black patients (HR, 1.2; 95% CI, 0.4-3.5) and White patients (HR, 1.4; 95% CI, 0.8-2.6) after matching.
In the Optum cohort, White patients treated with carfilzomib had a significantly increased risk of heart failure hospitalization compared to those not treated with carfilzomib (HR, 2.4; 95% CI, 1.0-5.4) after matching. This analysis was not performed for Black patients in the Optum cohort due to small sample size.
“While the incidence rate of heart failure hospitalization among patients with MM treated with a carfilzomib-based regimen was slightly higher, there was no evidence to suggest that the relative risk was different between White and Black patients with MM,” the researchers concluded.
Disclosures: This research was supported by Amgen, Inc. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Reference
Li S, Suehs BT, Fu A, et al. Heart failure among patients with multiple myeloma treated with carfilzomib-based versus non–carfilzomib-based regimens in the United States by race. Clin Lymphoma Myeloma Leuk. Published online April 27, 2023. doi:10.1016/j.clml.2023.04.009
This article originally appeared on Cancer Therapy Advisor
