Racial Disparities in Bisphosphonate Use Among Older Patients with Myeloma

A new study showed evidence of racial disparities in the use of intravenous (IV) bisphosphonates among older patients with multiple myeloma (MM).

Bisphosphonates are used to prevent skeletal complications in patients with MM. Real-world data on racial differences in IV bisphosphonate use is limited. In this retrospective study, researchers evaluated population-level IV bisphosphonate initiation and discontinuation among older patients with MM.

The team collected data on patients with MM aged older than 65 years from the years 2001 and 2011, utilizing the SEER-Medicare database. They compared total incidence of IV bisphosphonate initiation and time to discontinuation between racial and ethnic groups. More than 14000 patients were included in the analysis, of which 52% were male and the median age was 76 years. The racial makeup of the study group was 10456 non-Hispanic white, 2267 Black, 548 Asian/Pacific Islander, and 815 Hispanic/Latino patients.

During a median 23.1-month follow-up, 54% of patients had received at least one dose of IV bisphosphonate. The data showed that more white patients initiated bisphosphonate treatment following diagnosis with MM compared with Black patients (56.1% vs. 45.4%, respectively).

Compared with white patients, Black patients with MM were overall less likely to initiate IV bisphosphonate treatment (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.70-0.79) and more likely to discontinue treatment (HR, 1.10; 95% CI, 1.01-1.19).

“Approximately half of the patients with MM of age ≥65 years did not receive IV bisphosphonates, with significant delay among racial minority groups. These findings highlight the need for improvement of IV bisphosphonate uptake in patients with MM aged 65 years or older,” the researchers concluded.

This study was published in JCO Oncology Practice.

Reference

Zhou J, Sweiss K, Nutescu EA, et al. Racial Disparities in Intravenous Bisphosphonate Use Among Older Patients With Multiple Myeloma Enrolled in Medicare. JCO Oncol Pract. 2021 Mar;17(3):e294-e312.