Controversies in the use of new bone-modifying therapies in multiple myeloma.
Br J Haematol
; 193(6): 1034-1043, 2021 Jun.
Article
in English
| MEDLINE | ID: covidwho-949386
ABSTRACT
Bone-modifying therapies are essential in the treatment of patients with multiple myeloma. Zoledronic acid is preferred over other bisphosphonates due to its superiority in reducing the incidence of skeletal-related events and improving survival. The anti-receptor activator of nuclear factor-κΒ ligand (RANKL)-targeted agent denosumab has shown its non-inferiority compared to bisphosphonates in preventing skeletal-related events among newly diagnosed patients with myeloma bone disease. Denosumab may confer a survival benefit in patients eligible for autologous transplantation. Denosumab may present a safer profile for patients with renal impairment. Discontinuation of bone-directed therapies can be considered for patients with deep responses and after an adequate time period on treatment; however, a rebound effect may become evident especially in the case of denosumab. Three-monthly infusions of zoledronic acid or at-home denosumab administration should be considered during the coronavirus disease 2019 (COVID-19) pandemic. Measures to prevent hypocalcaemia, renal toxicity and osteonecrosis of the jaw are important for all bone-modifying agents.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Diphosphonates
/
Bone Density Conservation Agents
/
Receptor Activator of Nuclear Factor-kappa B
/
Denosumab
/
Multiple Myeloma
Type of study:
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
Br J Haematol
Year:
2021
Document Type:
Article
Affiliation country:
Bjh.17256
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