Which Patients With Ulcerative Colitis Are at Increased Risk for Multiple Myeloma?

Black men with ulcerative colitis (UC) who have obesity and adults aged over 64 years have an increased risk for multiple myeloma (MM), according to study results published in the journal Diseases.

Researchers sourced data from the National Inpatient Sample on adults aged 18 years and older with complete information on sex and age; ICD-10 codes were used to identify individuals with MM and UC.

Researchers compared data using a logistic regression model that controlled for sex and age. The study authors also employed the software STATA 16.1. for all statistical tests.

A total of 393,630 patients with UC and 367,415 with MM were identified. The crude prevalence of MM in individuals with UC (n=1750) was 0.44%, compared with 0.37% among individuals without UC (n=366,265).

After multivariable analysis that adjusted for sex, age, ethnicity, and BMI, the researchers found that individuals with UC showed increased overall odds of an MM diagnosis (odds ratio [OR], 1.26; 95% CI, 1.04-1.58).

Subgroup analysis showed a higher prevalence of MM among men with UC compared with women with UC (53.7% vs 46.3%). Black patients with UC had a higher prevalence of MM than White individuals with UC (15.6% vs 9.2%). Individuals with UC who were 65 years and older had a higher prevalence of MM than younger individuals with UC (70.9% vs 29.1%). Individuals with UC who had obesity (BMI>30) had a higher prevalence of MM than individuals with UC who did not have obesity (12.6% vs 8.3%, respectively).

Study limitations include reliance on ICD codes, which may include administrative errors. In addition, the researchers could not analyze the UC severity, phenotype, extraintestinal manifestations, or UC-related complications from the data or whether UC and/or immunosuppressive therapy play a role in MM risk. All data are also from an inpatient setting, limiting the scope of clinical information it provides.

“[A] high degree of clinical suspicion of MM is warranted in patients with UC— especially in the demographic subgroups found to be at higher risk,” the study authors noted. “In this era of precision medicine and increasing use of biologics for treatment of UC, future prospective data are needed to evaluate the impact of immunosuppressive therapy on the development of hematologic malignancies in patients with UC.”

This article originally appeared on Gastroenterology Advisor