TY - JOUR
T1 - Association of proton pump inhibitor use with survival and adverse effects outcomes in patients with multiple myeloma
T2 - pooled analysis of three clinical trials
AU - Almansour, Sara A.
AU - Alqudah, Mohammad A.Y.
AU - Abuhelwa, Ziad
AU - Al-Shamsi, Humaid O.
AU - Semreen, Mohammad H.
AU - Bustanji, Yasser
AU - Soare, Nelson C.
AU - McKinnon, Ross A.
AU - Sorich, Michael J.
AU - Hopkins, Ashley M.
AU - Abuhelwa, Ahmad Y.
PY - 2024/1/5
Y1 - 2024/1/5
N2 - Proton pump inhibitors (PPIs) are commonly used in cancer patients, but their impact on treatment outcomes in multiple myeloma (MM) patients remains unclear. This study investigated the association of PPI use with survival and adverse effects in MM patients across three randomized-control trials initiating daratumumab, lenalidomide, or bortezomib combination treatments. Cox proportional hazard analysis and logistic regression were employed to assess the associations with treatment outcomes, while adjusting for age, sex, weight, MM international staging system stage, ECOG-performance status, comorbidity count, and presence of gastrointestinal disorders. Pooled data involving 1804 patients revealed that 557 (32%) used PPIs at baseline. PPI use was independently associated with worse overall survival (adjusted HR [95% CI] 1.32 [1.08–1.62], P = 0.007) and grade ≥ 3 adverse events (adjusted OR [95% CI] 1.39 [1.03–1.88], P = 0.030). However, the association with progression-free survival did not reach statistical significance (adjusted HR [95% CI] 1.14 [0.97–1.33], P = 0.112). Findings were consistent across trials and treatment arms. PPI use was identified as a negative prognostic factor in MM patients, potentially enhancing clinical decisions regarding its use. Further research is needed to fully comprehend the impacts and safety of PPI use in MM patients.
AB - Proton pump inhibitors (PPIs) are commonly used in cancer patients, but their impact on treatment outcomes in multiple myeloma (MM) patients remains unclear. This study investigated the association of PPI use with survival and adverse effects in MM patients across three randomized-control trials initiating daratumumab, lenalidomide, or bortezomib combination treatments. Cox proportional hazard analysis and logistic regression were employed to assess the associations with treatment outcomes, while adjusting for age, sex, weight, MM international staging system stage, ECOG-performance status, comorbidity count, and presence of gastrointestinal disorders. Pooled data involving 1804 patients revealed that 557 (32%) used PPIs at baseline. PPI use was independently associated with worse overall survival (adjusted HR [95% CI] 1.32 [1.08–1.62], P = 0.007) and grade ≥ 3 adverse events (adjusted OR [95% CI] 1.39 [1.03–1.88], P = 0.030). However, the association with progression-free survival did not reach statistical significance (adjusted HR [95% CI] 1.14 [0.97–1.33], P = 0.112). Findings were consistent across trials and treatment arms. PPI use was identified as a negative prognostic factor in MM patients, potentially enhancing clinical decisions regarding its use. Further research is needed to fully comprehend the impacts and safety of PPI use in MM patients.
KW - Cancer
KW - Combination drug therapy
KW - Myeloma
UR - http://www.scopus.com/inward/record.url?scp=85181456013&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/2008119
U2 - 10.1038/s41598-023-48640-1
DO - 10.1038/s41598-023-48640-1
M3 - Article
C2 - 38182614
AN - SCOPUS:85181456013
SN - 2045-2322
VL - 14
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 591
ER -
