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Controversies in the use of new bone-modifying therapies in multiple myeloma.
Terpos, Evangelos; Ntanasis-Stathopoulos, Ioannis.
  • Terpos E; Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
  • Ntanasis-Stathopoulos I; Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
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.
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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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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