Denosumab and bisphosphonates in multiple myeloma in 2019
Authors:
Z. Král; Z. Adam; M. Krejčí; L. Pour; V. Sandecká; M. Štork
Authors‘ workplace:
Interní hematologická a onkologická klinika LF MU a FN Brno
Published in:
Transfuze Hematol. dnes,25, 2019, No. 4, p. 320-329.
Category:
Review/Educational Papers
Overview
More than 80% of patients with multiple myeloma display evidence of myeloma bone disease (MBD) characterised by the formation of osteolytic lesions throughout the axial and appendicular skeleton. MBD significantly increases the risk of skeletal-related events such as pathological fractures, spinal cord compression and hypercalcaemia. MBD is the result of MM plasma cell-mediated activation of osteoclast activity and suppression of osteoblast activity. The activity of osteoclasts can be suppressed using bisphosphonates (BP) or denosumab. Although generally safe, frequent high doses of BP are associated with adverse events such as renal toxicity and osteonecrosis of the jaw and atypical fractures. As such, optimal duration and dosing of BP therapy is required in order to minimise BP-associated adverse events. The following review provides currently available evidence for the adoption of a tailored approach when using BP for the management of MBD.
Keywords:
bisphosphonates – medication related osteonecrosis of the jaw – atypical fractures – Multiple myeloma
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