Bortezomib does not increase cardiac risk in multiple myeloma

This study analyzed the results of multiple studies to examine the effect of bortezomib (Velcade) on cardiac risk (heart health) in multiple myeloma. Results showed no effect on cardiac risk with bortezomib-based treatment. The incidence of cardiac events was low across all treatment groups.

Many multiple myeloma patients relapse after primary treatment. Other patients may stop responding to standard treatment. This is known as refractory disease. New treatment options are needed for patients who have received multiple prior treatments.

Bortezomib is a proteasome inhibitor. A proteasome is a molecule involved in cell growth and death. Blocking proteasome can decrease cancer cell growth and increase cancer cell death. Studies have shown bortezomib to be an effective therapy for multiple myeloma. However, there are some reports of cardiac-related (heart) side effects with bortezomib, which need to be further investigated.

This study pooled the results of 6 separate trials into a single analysis. In total, 2,509 multiple myeloma patients had received bortezomib-based treatment. They were compared to 1,445 multiple myeloma patients not treated with bortezomib. The incidence of cardiac events and cardiac disease occurring up to 30 days after the end of treatment were recorded.

The risk of severe heart failure was not significantly increased with bortezomib-based treatment. Severe heart failure occurred in 1.3 to 4% of patients with relapsed or refractory disease treated with bortezomib. It was 1.2 to 4.7% for newly diagnosed multiple myeloma treated with bortezomib.

Incidences of arrhythmia (abnormal heart rhythm), heart disease, and cardiac death were low with no significant differences between the two treatment groups.

Cardiac risk factors, such as high blood pressure and difficulty breathing, were low and not significantly increased with bortezomib-based treatment. Patients receiving bortezomib were 54% more likely to have fluid retention. 

This analysis of multiple studies showed no effect on cardiac risk with bortezomib-based treatment.