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Myeloma bone disease.

James R Berenson1

  • 1Institute for Myeloma and Bone Cancer Research, 9201 W. Sunset Blvd, Suite 300, W. Hollywood, CA 90069, USA. jberenson@myelomasource.org

Best Practice & Research. Clinical Haematology
|July 20, 2005
PubMed
Summary

Intravenous bisphosphonates, including pamidronate and zoledronic acid, effectively reduce skeletal complications in multiple myeloma patients. Oral bisphosphonates show limited efficacy, making IV infusions a cornerstone of current myeloma bone disease management.

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Area of Science:

  • Oncology
  • Bone Metabolism
  • Pharmacology

Background:

  • Multiple myeloma frequently causes osteolytic bone destruction, leading to severe complications like fractures and pain.
  • Bone disease significantly contributes to morbidity and mortality in multiple myeloma patients.
  • Current treatments for myeloma bone disease include radiation, surgery, and analgesics.

Purpose of the Study:

  • To evaluate the efficacy of bisphosphonates in managing bone disease in multiple myeloma.
  • To compare the effectiveness of oral versus intravenous bisphosphonate administration.

Main Methods:

  • Review of several large randomized trials involving multiple myeloma patients receiving chemotherapy.
  • Analysis of data comparing oral bisphosphonates with intravenous pamidronate or zoledronic acid infusions.

Main Results:

  • Orally administered bisphosphonates demonstrated limited success in slowing skeletal complications.
  • Monthly intravenous infusions of pamidronate or zoledronic acid significantly reduced skeletal complications.
  • Intravenous bisphosphonates are now a standard therapy for multiple myeloma bone disease.

Conclusions:

  • Intravenous bisphosphonates are highly effective in mitigating skeletal-related events in multiple myeloma.
  • Pamidronate and zoledronic acid represent a mainstay in managing myeloma-associated bone disease.
  • New anti-bone-resorptive agents are under investigation for future therapeutic options.

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