title: Established role of bisphosphonate therapy for prevention of skeletal complications from myeloma bone disease.
abstract: Patients with advanced multiple myeloma (MM) often have increased osteolytic activity of osteoclasts and impaired osteogenesis by osteoblasts, resulting in osteolytic bone lesions that increase the risk of skeletal-related events (SREs) including pathologic fracture, the need for radiotherapy or surgery to bone, and spinal cord compression. Such SREs are potentially life-limiting, and can reduce patients' functional independence and quality of life. Bisphosphonates (e.g., oral clodronate and intravenous pamidronate and zoledronic acid) can inhibit osteoclast-mediated osteolysis, thereby reducing the risk of SREs, ameliorating bone pain, and potentially prolonging survival in patients with MM. Extensive clinical experience demonstrates that bisphosphonates are generally well tolerated, and common adverse events are typically mild and manageable. Studies are ongoing to optimize the timing and duration of bisphosphonate therapy in patients with bone lesions from MM.
authors.affiliation: Department of Clinical Therapeutics, University of Athens School of Medicine, Athens, Greece. eterpos@med.uoa.gr
authors.forename: Evangelos
authors.initials: E
authors.lastname: Terpos
authors.forename: Meletios A
authors.initials: MA
authors.lastname: Dimopoulos
authors.forename: James
authors.initials: J
authors.lastname: Berenson
mesh_terms: D000818:Animals; D050071:Bone Density Conservation Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D001842:Bone and Bones / Q000187:drug effects* / Q000473:pathology; D001943:Breast Neoplasms / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D002986:Clinical Trials as Topic; D004002:Clodronic Acid / Q000008:administration & dosage / Q000627:therapeutic use; D004164:Diphosphonates / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage* / Q000627:therapeutic use; D051379:Mice; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control; D010014:Osteolysis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D000077268:Pamidronate; D012307:Risk Factors; D013117:Spinal Cord Compression / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D004002:Clodronic Acid; D000077211:Zoledronic Acid; D000077268:Pamidronate