title: Management of bone disease in multiple myeloma.
abstract: Osteolytic bone disease is the most common complication of multiple myeloma, resulting in skeletal complications that cause significant morbidity and mortality. Currently, bisphosphonates (BPs) are the mainstay for the treatment of myeloma bone disease. Zoledronic acid which has been found to be superior to clodronate, both in terms of reduction of skeletal-related events (SREs) and survival, and pamidronate are used for the management of myeloma-related bone disease. Patients with active disease (not in CR or VGPR) should receive BPs (especially zoledronic acid) even after two years of administration. Radiotherapy and surgical interventions can also be used for specific conditions, such as pathological fractures, spinal cord compression or uncontrolled pain. The better understanding of the biology of myeloma bone disease has led to the production of several novel agents, such as denosumab (targeting RANKL), sotatercept (activin-A antagonist) and romosozumab (targeting sclerostin) that appear very promising and have entered to clinical development.
authors.affiliation: Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital, 80 Vas. Sofias Avenue, 11528 Athens, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Terpos
authors.forename: James
authors.initials: J
authors.lastname: Berenson
authors.forename: Noopur
authors.initials: N
authors.lastname: Raje
authors.forename: G David
authors.initials: GD
authors.lastname: Roodman
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001847:Bone Diseases / Q000150:complications / Q000188:drug therapy* / Q000532:radiotherapy; D004164:Diphosphonates / Q000627:therapeutic use*; D056572:Histone Deacetylase Inhibitors / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D058498:Kyphoplasty; D009101:Multiple Myeloma / Q000150:complications* / Q000188:drug therapy; D011480:Protease Inhibitors / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use
chemical_list: D000911:Antibodies, Monoclonal; D004164:Diphosphonates; D056572:Histone Deacetylase Inhibitors; D007155:Immunologic Factors; D011480:Protease Inhibitors; D011993:Recombinant Fusion Proteins; C542017:sotatercept