Supportive Care in Cancer

, Volume 26, Issue 3, pp 807–812 | Cite as

Utilization of agents to prevent skeletal-related events among patients with multiple myeloma: analysis of real-world data

  • Yi QianEmail author
  • Debajyoti Bhowmik
  • Nandita Kachru
  • Rohini K Hernandez
  • Paul Cheng
  • Alexander Liede
Original Article



This study examined real-world utilization patterns of bone-targeted agents (BTA) in patients with multiple myeloma (MM).


In this retrospective cohort study, adults with an MM diagnosis recorded in 2012–2014 were identified from electronic health records in the Oncology Services Comprehensive Electronic Records (OSCER) database. Patients received zoledronic acid (ZA) or pamidronate (PA) on/after first MM diagnosis recorded in the study period, had no BTA use in prior 6 months, and were followed through earliest of May 31, 2015 or last clinic visit. Patients with any solid tumor diagnosis were excluded. Time to BTA initiation, compliance (≥ 12 administrations in a year), switching, and non-persistence (switch or ≥ 90-day gap in therapy) were described by agent and follow-up period.


Among 9,617 patients with MM, 3,735 (38.8%) received a BTA. Most patients (90.9%) received ZA, with first BTA use generally seen within 3 months of first observed MM diagnosis (ZA 76.1%, PA 75.1%). A minority of ZA (27.4%) and PA (23.0%) patients were compliant in Year 1, with lower compliance in Year 2 (19.8% and 15.6%, respectively). The median time to non-persistence was 16.2 (95% confidence interval [CI] 15.4–17.4) months for ZA and 13.8 (95% CI 11.5–15.4) months for PA. Persistence was 86% at 6 months and 34% at 24 months for ZA, and 77% and 30% for PA, respectively.


These results highlight the possibility of suboptimal prevention of skeletal-related events due to non-compliant dosing and non-persistence after patients initiate BTA therapy.


Bone metastasis Multiple myeloma Bone-targeted agents Persistence Compliance 



This study was funded by Amgen Inc., Thousand Oaks, CA. YQ, DB, RKH, and AL are employees and stockholders of Amgen Inc. and have access to the primary study data. PC and NK were employed by Amgen Inc. at the time of the study. Writing assistance was provided by Sally Wade, Wade Outcomes Research and Consulting, Salt Lake City, UT.

Compliance with ethical standards

Conflicts of interest

This study was funded by Amgen Inc., Thousand Oaks, CA. YQ, DB, RKH and AL are employees and stockholders of Amgen Inc. and have access to the primary study data. NK and PC were employed by Amgen Inc. at the time of the study. Writing assistance was provided by Sally Wade, Wade Outcomes Research and Consulting, Salt Lake City, UT.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Yi Qian
    • 1
    Email author
  • Debajyoti Bhowmik
    • 1
  • Nandita Kachru
    • 2
  • Rohini K Hernandez
    • 1
  • Paul Cheng
    • 1
  • Alexander Liede
    • 3
  1. 1.Amgen Inc.Thousand OaksUSA
  2. 2.Department of Pharmaceutical Health Outcomes and Policy, College of PharmacyUniversity of HoustonHoustonUSA
  3. 3.Amgen Inc.South San FranciscoUSA

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