In this prospective real-world cohort of 209 patients with multiple myeloma, current proteasome inhibitor-based treatment was not associated with measurable differences in global patient-reported outcomes, overall bone pain, or prevalent osteolytic lesions compared with non-PI-based treatment.
About 37% of the 209 enrolled multiple myeloma patients were currently receiving PI-based treatment.
Current PI-based treatment status was not associated with Quality of Life in adjusted analyses.
Current PI-based treatment status was not associated with health-related status in adjusted analyses.
Overall bone pain did not differ significantly by PI-based treatment status after adjustment.
Prevalent osteolytic lesions were not significantly associated with current PI-based treatment.
Quality of Life and health-related status remained comparable between groups during follow-up.
MM-related bone pain was numerically more frequent in patients currently receiving PI-based treatment, but the association was not statistically significant after multivariable adjustment.
The findings do not establish whether the biological effects of PIs on bone remodeling translate into clinically meaningful patient-reported or structural skeletal benefits.
This study followed 209 people with multiple myeloma, a blood cancer that often damages bones, during routine clinic visits. It compared those currently on proteasome inhibitor drugs (about 37% of patients) with those on other treatments. Proteasome inhibitors are known in laboratory studies to affect bone remodeling, so the researchers wanted to know whether this showed up in how patients felt or in their bone symptoms. After accounting for differences between the groups, the researchers found no clear differences in quality of life, general health status, overall bone pain, or the presence of bone lesions. A subset of 69 patients reassessed at least six months later also showed similar quality of life and health status. Myeloma-related bone pain was somewhat more common among those on proteasome inhibitors (46% vs. 33%), but this difference could have arisen by chance after adjustment. This research suggests that, in everyday care, being on a proteasome inhibitor is not obviously linked to better or worse patient-reported outcomes or bone findings. Because doctors tend to choose these drugs for patients with more active or symptomatic disease, and because this was an observational study with a modest sample, the results cannot show whether the drugs benefit bones. They describe real-world patterns rather than prove cause and effect.
Maier J, Pietsch C, Schmal H, Ntanasis-Stathopoulos I, Terpos E, Ihorst G, et al.. (2026). Patient-reported outcomes and skeletal symptoms in multiple myeloma stratified by proteasome inhibitor-based therapy: a prospective interdisciplinary cohort study.. BMC cancer. https://doi.org/10.1186/s12885-026-17177-7