Exploring racial disparities in treatment patterns and outcomes for patients with multiple myeloma using real world data.

ABSTRACT

This retrospective observational study evaluated racial disparities among Black and White patients with multiple myeloma (MM). We included patients from a longitudinal de-identified EHR-derived database who had ≥2 visits recorded on or after 1/1/2011, documented treatment, and race listed as White or Black. Black patients (n = 1172) were more likely female (54.8%/42.9%) and younger (<65 years, 40.8%/30.8%) than White patients (n = 4637). Unadjusted median real-world overall survival (rwOS) indexed to first-line of therapy (LOT) was 64.6 months (95% CI 57.8-74.0) for Blacks and 54.5 months (95% CI 50.9-56.2) for Whites. Adjusted rwOS estimates (for sex, age at index date, and practice type) to either first- (aHR = 0.94; 95% CI 0.84-1.06) or second-LOT (aHR = 0.90; 95% CI 0.77-1.05) were similar. Unadjusted derived response rate (dRR) during first-LOT was 84.8% (95% CI 80.7-88.1) for Blacks and 86.9% (95% CI 85.0-88.5) for Whites (odds ratio [OR] = 0.78 [95% CI 0.57-1.10]); in second-LOT, 67.2% (95% CI 58.4-75.0) for Blacks and 72.4% (95% CI 68.1-76.3) for Whites (OR = 0.72 [95% CI 0.46-1.13]). High representation of Black patients enabled this robust analysis, albeit with limitations inherent to the observational data source, the retrospective design, and the analytic use of newly derived endpoints requiring further validation.