Evidence map›Paper›PMID 42680232›Full record

SynthesisOpen heart2026

Cardiovascular disease and amyloidosis in phase III multiple myeloma trials: a systematic review of eligibility, screening and event reporting.

Oliver Henriques Peck, Aimee McCoubrey, John A Snowden, Ashutosh Wechalekar, Jennifer Travers, Jennifer S Lees, Mark C Petrie, Ninian N Lang

Abstract readSystematic Review
In one paragraph

Synthesis in Open heart, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Oliver Henriques PeckSchool of Cardiovascular and Metabolic Health, College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK oliver.henriquespeck@glasgow.ac.uk Ninian.Lang@Glasgow.ac.uk.ORCID http://orcid.org/0009-0004-8121-682X
Aimee McCoubreySchool of Cardiovascular and Metabolic Health, College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK.ORCID http://orcid.org/0009-0003-2813-6188
John A SnowdenDepartment of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Ashutosh WechalekarUniversity College London (Royal Free Campus), National Amyloidosis Centre, London, UK.
Jennifer TraversSchool of Cardiovascular and Metabolic Health, College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK.
Jennifer S LeesSchool of Cardiovascular and Metabolic Health, College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK.
Mark C PetrieSchool of Cardiovascular and Metabolic Health, College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK.
Ninian N LangSchool of Cardiovascular and Metabolic Health, College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK oliver.henriquespeck@glasgow.ac.uk Ninian.Lang@Glasgow.ac.uk.

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundCardiovascular disease (CVD) and light chain (AL) amyloidosis are important causes of morbidity and mortality in patients with multiple myeloma (MM). Additionally, MM therapies can have cardiovascular effects. However, the extent to which phase III MM trials account for underlying CVD and amyloidosis through eligibility criteria, screening and reporting remains uncertain. These elements of trial design and reporting are essential for accurate interpretation of cardiovascular safety signals.

objectivesTo examine practice-changing MM trials with respect to amyloidosis and CVD eligibility criteria, assessment for cardiac amyloidosis, reporting of baseline cardiovascular characteristics and cardiovascular adverse events (CVAE).

methodsSystematic review of phase III randomised controlled trials of MM drug therapies published in English between 2015 and 2025, identified by searching MEDLINE, Embase and Cochrane Library. Eligible trials enrolled adults aged ≥18 years with MM and included ≥100 patients per treatment group; non-randomised, subgroup and abstract-only reports were excluded.

results41 trials enrolling 20 144 participants were included. Amyloidosis was an exclusion criterion in 30 trials typically using non-specific definitions. No trial reported active screening for amyloidosis or assessment of cardiac involvement. Baseline cardiovascular investigations were common but were not used to identify cardiac amyloidosis. At least one cardiovascular exclusion criterion was present in 98% of trials, most commonly heart failure and recent myocardial infarction. Baseline cardiovascular characteristics were reported in only one trial. CVAEs were investigator-reported, inconsistently defined and not centrally adjudicated.

conclusionsPhase III MM trials frequently incorporate amyloidosis and CVD exclusion criteria. However, the prevalence of cardiac amyloidosis and other CVD within these practice-changing MM trials remains poorly defined and CVAE reporting remains suboptimal. These limitations may bias safety and efficacy outcomes and reduce trial generalisability. PROSPERO REGISTRATION NUMBER: CRD420251125097.

Indexed as

AmyloidosisAntineoplastic AgentsCardiovascular DiseasesClinical Trials, Phase III as TopicMultiple MyelomaHumansRandomized Controlled Trials as TopicAntineoplastic AgentsAmyloidosisQuality of Health CareSystematic Reviews as Topic

Identifiers

PMID42680232
PMCPMC13536086

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.