Cardiovascular outcomes and mortality in diabetic multiple myeloma patients initiated on proteasome inhibitors according to prior use of glucagon-like peptide 1 agonists - Report - MDSpire
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Cardiovascular outcomes and mortality in diabetic multiple myeloma patients initiated on proteasome inhibitors according to prior use of glucagon-like peptide 1 agonists
Impact of GLP-1 Agonists on Cardiovascular Events and Mortality in MM Patients with T2DM
Overview
In patients with multiple myeloma (MM) and type 2 diabetes mellitus (T2DM) treated with proteasome inhibitors, prior use of glucagon-like peptide 1 agonists (GLP1a) was associated with a significant reduction in major adverse cardiovascular events (MACE) and all-cause mortality. GLP1a use did not increase the risk of adverse safety events in this population.
Background
Proteasome inhibitors are standard treatments for MM but carry risks of cardiovascular complications such as heart failure and ischemic heart disease. Patients with T2DM have an elevated baseline risk of cardiovascular disease. GLP1a medications have demonstrated cardiovascular protective effects in diabetic populations, but their impact on MM patients receiving proteasome inhibitors had not been studied. This study aimed to evaluate the association between GLP1a use and cardiovascular outcomes in this high-risk group.
Data Highlights
Outcome
GLP1a Cohort (n=202)
Non-GLP1a Cohort (n=202)
Hazard Ratio (95% CI)
Major Adverse Cardiovascular Events (MACE)
68 events
94 events
0.67 (0.49–0.92)
Heart Failure
20 events
34 events
0.57 (0.33–0.99)
Myocardial Infarction
Not significantly different
Not significantly different
NS
Atrial Fibrillation
Not significantly different
Not significantly different
NS
Ischemic Stroke
Not significantly different
Not significantly different
NS
All-Cause Mortality
21 deaths
38 deaths
0.56 (0.33–0.95)
Key Findings
GLP1a use was associated with a 33% reduction in risk of major adverse cardiovascular events compared to non-GLP1a diabetic medications.
There was a 43% lower risk of incident heart failure in the GLP1a cohort.
No significant differences were observed in rates of myocardial infarction, atrial fibrillation, or ischemic stroke between cohorts.
GLP1a use was linked to a 44% reduction in all-cause mortality over one year.
No increased risk of serious adverse events such as pancreatitis, biliary disease, bowel obstruction, or gastroparesis was found with GLP1a use.
Clinical Implications
These findings suggest that GLP1a therapy may provide cardiovascular protection and survival benefits in MM patients with T2DM undergoing proteasome inhibitor treatment. Clinicians should consider GLP1a as a preferred glucose-lowering option in this population to potentially mitigate proteasome inhibitor-associated cardiovascular risks without added safety concerns.
Conclusion
Prior GLP1a use in diabetic MM patients treated with proteasome inhibitors is associated with reduced cardiovascular events and mortality without increased adverse events, supporting its role in improving cardiovascular outcomes in this high-risk group.
References
Study Authors/Source/2024 -- Impact of Prior Glucagon-Like Peptide 1 Agonist Use on Cardiovascular Events and Mortality in Diabetic Patients with Multiple Myeloma Treated with Proteasome Inhibitors
