Inappropriate polypharmacy tied to fall risk, neuropathy in older patients with multiple myeloma

Inappropriate polypharmacy is prevalent in older patients with multiple myeloma, a recent study has shown, noting that drugs affecting balance and perception must be reconsidered in these individuals.

“Polypharmacy is an increasing problem in the care of older patients,” the authors said, adding that polypharmacy is almost unavoidable in those with multiple myeloma.

Eighty patients with multiple myeloma (aged >65 years) were enrolled retrospectively. The authors determined patient files, prescriptions and evaluations for polypharmacy according to the Beers and START/STOPP criteria. They also recorded outcomes in fractures, autonomous neuropathy and renal functions from files.

Of the patients, 65 had polypharmacy with ≥4 drugs and 51 with ≥5 drugs.

Poor ECOG performance in women was associated with autonomous neuropathy, polypharmacy with more than four or five medications, and use of multiple medications in the same category. In men, poor ECOG performance status correlated with prolonged use of benzodiazepines and central nervous system-affecting drugs and inappropriate polypharmacy.

Inappropriate polypharmacy was more commonly observed in patients aged 75–84 years. Moreover, the risk of fall and autonomous neuropathy appeared to be significantly associated with inappropriate polypharmacy.

“Multiple myeloma is a chronic, uncurable haematological cancer with the involvement of multiple organ systems,” the authors said. “As a disease affecting older patients, the treatment of multiple myeloma should be based on individual patient characteristics.”