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

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.