{
  "abstract": "Background\n\nMultiple myeloma (MM) frequently causes osteolytic bone disease and skeletal symptoms. Proteasome inhibitors (PIs) are central to MM treatment and in routine practice, PI-based therapy is preferentially selected for patients with more active or symptomatic disease. Hereby, PIs may also exert bone-modulating effects beyond their antimyeloma activity. Whether these biological effects are reflected in patient-reported outcomes or skeletal symptoms during routine care remains unclear.Methods\n\nWe prospectively enrolled 209 patients with MM during routine interdisciplinary follow-up and stratified them by current PI-based versus non-PI-based treatment status. Sixty-nine patients were reassessed after at least 6 months. Patient-reported outcomes and skeletal symptoms were evaluated using multivariable regression and sensitivity analyses addressing baseline imbalances and treatment selection.Results\n\nSeventy-eight patients (37%) were currently receiving PI-based treatment. In adjusted analyses, current PI-based treatment status was not associated with Quality of Life (β = -0.08, 95% CI -0.45 to 0.29; p = 0.662), health-related status (β = -0.06, 95% CI -0.42 to 0.30; p = 0.740), bone pain (OR 0.92, 95% CI 0.48 to 1.74; p = 0.791), or prevalent osteolytic lesions (OR 1.26, 95% CI 0.53 to 2.96; p = 0.601). QoL and health-related status remained comparable during follow-up. MM-related bone pain was numerically more frequent among patients currently receiving PI-based treatment (46% vs. 33%), although the association did not reach statistical significance after multivariable adjustment (OR 1.80, 95% CI 0.93 to 3.48; p = 0.081).Conclusions\n\nIn this prospective real-world cohort, current PI-based treatment status was not associated with measurable differences in global patient-reported outcomes, overall bone pain, or prevalent osteolytic lesions compared with non-PI-based treatment. MM-related bone pain was numerically more frequent among patients currently receiving PI-based treatment, although the association did not reach statistical significance after multivariable adjustment. These findings provide a real-world description of patient-reported and skeletal outcomes according to current treatment status but do not establish whether the biological effects of proteasome inhibitors on bone remodeling translate into clinically meaningful patient-reported or structural skeletal benefits.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Orthopedics and Trauma Surgery, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany. julian.maier@uniklinik-freiburg.de.",
    "Comprehensive Cancer Center Freiburg (CCCF), Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany. julian.maier@uniklinik-freiburg.de.",
    "Department of Orthopedics and Trauma Surgery, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany.",
    "Comprehensive Cancer Center Freiburg (CCCF), Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany.",
    "Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.",
    "Clinical Trials Unit, Medical Center, Faculty of Medicine, Medical Clinic, University of Freiburg, Freiburg, Germany.",
    "Department of Medicine, Hematology and Oncology, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Julian P Maier",
      "orcid": "0000-0002-2957-9031"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Carlotta Pietsch"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Hagen Schmal"
    },
    {
      "affs": [
        4
      ],
      "name": "Ioannis Ntanasis-Stathopoulos"
    },
    {
      "affs": [
        4
      ],
      "name": "Evangelos Terpos"
    },
    {
      "affs": [
        5
      ],
      "name": "Gabriele Ihorst"
    },
    {
      "affs": [
        3,
        6
      ],
      "name": "Ralph Wäsch"
    },
    {
      "affs": [
        3,
        6
      ],
      "name": "Monika Engelhardt"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Georg W Herget"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7r1pqwy59pgvx.bib",
  "cited_by": 0,
  "doi": "10.1186/s12885-026-17177-7",
  "fulltext_url": "https://europepmc.org/articles/PMC13695283",
  "id": "7r1pqwy59pgvx",
  "issns": [
    "1471-2407"
  ],
  "landing_url": "https://europepmc.org/article/MED/42926231",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC254-282"
    ],
    [
      "openalex",
      "2720|Multiple Myeloma Research and Treatments"
    ]
  ],
  "openalex": "W7222190184",
  "pdf_url": "https://europepmc.org/articles/PMC13695283?pdf=render",
  "pmcid": "PMC13695283",
  "pmid": "42926231",
  "published": "2026-10-15",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/7r1pqwy59pgvx.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:18Z",
      "native_id": "MED:42926231",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42926231"
    },
    {
      "first_seen": "2026-10-30T13:46:03Z",
      "native_id": "8d75be52a2db4a2d986f55a4ef7ae01f",
      "source": "doaj",
      "url": "https://doi.org/10.1186/s12885-026-17177-7"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:RC254-282",
      "subfield": "oncology"
    }
  ],
  "title": "Patient-reported outcomes and skeletal symptoms in multiple myeloma stratified by proteasome inhibitor-based therapy: a prospective interdisciplinary cohort study.",
  "title_text": "Patient-reported outcomes and skeletal symptoms in multiple myeloma stratified by proteasome inhibitor-based therapy: a prospective interdisciplinary cohort study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:46:03Z",
  "url": "https://research.draconitic.com/paper/7r1pqwy59pgvx",
  "venue": "BMC cancer",
  "versions": []
}