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Related Experiment Videos

Bisphosphonates in multiple myeloma.

B Djulbegovic1, K Wheatley, J Ross

  • 1Dpt. of Internal Medicine I, Univ. of Bonn, Sigmund-Freud-Str. 25, Bonn, Germany, 53105. glasmacher@uni-bonn.de

The Cochrane Database of Systematic Reviews
|November 1, 2001
PubMed
Summary
This summary is machine-generated.

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Bisphosphonates significantly reduce pathological vertebral fractures and pain in multiple myeloma patients. However, current evidence does not show a benefit in reducing mortality or non-vertebral fractures.

Area of Science:

  • Oncology
  • Pharmacology
  • Bone Metabolism

Background:

  • Multiple myeloma involves plasma cell proliferation leading to bone destruction.
  • Bisphosphonates inhibit osteoclastic activity, suggesting a therapeutic role.
  • The precise clinical impact of bisphosphonates in multiple myeloma requires clarification.

Purpose of the Study:

  • To evaluate bisphosphonates' effect on skeletal morbidity and mortality in multiple myeloma.
  • To assess bisphosphonates' impact on pain, quality of life, and hypercalcemia.

Main Methods:

  • Comprehensive literature search of randomized trials in multiple myeloma.
  • Inclusion of trials comparing bisphosphonates with placebo or no treatment.
  • Independent data extraction and quality assessment by two reviewers.

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Main Results:

  • Eleven trials with 2183 patients analyzed showed bisphosphonates prevent vertebral fractures (OR=0.59) and reduce pain (OR=0.59).
  • Absolute risk reduction indicates treating 10 patients prevents one vertebral fracture and 11 patients prevents pain.
  • No significant effect on mortality, non-vertebral fractures, or hypercalcemia was observed.

Conclusions:

  • Bisphosphonates are effective in reducing pathological vertebral fractures and pain in multiple myeloma.
  • Clodronate or pamidronate may be preferred agents based on current evidence.
  • Further research may be needed to clarify long-term effects and optimal usage.