Bisphosphonate guidelines for treatment and prevention of myeloma bone disease

Oi Lin Lee, Noemi Horvath, Cindy Lee, Doug Joshua, Joy Ho, Jeff Szer, Hang Quach, Andrew Spencer, Simon Harrison, Peter Mollee, Andrew W. Roberts, Dipti Talaulikar, Ross Brown, Bradley Augustson, Silvia Ling, Wilfrid Jaksic, John Gibson, Anna Kalff, Anna Johnston, Akash Kalro & 3 others Chris Ward, H. Miles Prince, Andrew Zannettino

Research output: Contribution to journalLetter

7 Citations (Scopus)

Abstract

Multiple myeloma (MM) is a haematological malignancy characterised by the clonal proliferation of plasma cells in the bone marrow. More than 80% of patients with MM 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 pathologic fracture, spinal cord compression and hypercalcaemia. MBD is the result of MM plasma cells-mediated activation of osteoclast activity and suppression of osteoblast activity. Bisphosphonates (BP), pyrophosphate analogues with high bone affinity, are the only pharmacological agents currently recommended for the treatment and prevention of MBD and remain the standard of care. Pamidronate and zoledronic acid are the most commonly used BP to treat MBD. Although generally safe, frequent high doses of BP are associated with adverse events such as renal toxicity and osteonecrosis of the jaw. As such, optimal duration and dosing of BP therapy is required in order to minimise BP-associated adverse events. The following guidelines provide currently available evidence for the adoption of a tailored approach when using BP for the management of MBD.

LanguageEnglish
Pages938-951
Number of pages14
JournalInternal Medicine Journal
Volume47
Issue number8
DOIs
Publication statusPublished - 1 Aug 2017

Keywords

  • bisphosphonate
  • myeloma
  • osteoblast
  • osteoclast
  • osteolysis
  • skeletal-related event (SRE)

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Lee, O. L., Horvath, N., Lee, C., Joshua, D., Ho, J., Szer, J., ... Zannettino, A. (2017). Bisphosphonate guidelines for treatment and prevention of myeloma bone disease. Internal Medicine Journal, 47(8), 938-951. https://doi.org/10.1111/imj.13502
Lee, Oi Lin ; Horvath, Noemi ; Lee, Cindy ; Joshua, Doug ; Ho, Joy ; Szer, Jeff ; Quach, Hang ; Spencer, Andrew ; Harrison, Simon ; Mollee, Peter ; Roberts, Andrew W. ; Talaulikar, Dipti ; Brown, Ross ; Augustson, Bradley ; Ling, Silvia ; Jaksic, Wilfrid ; Gibson, John ; Kalff, Anna ; Johnston, Anna ; Kalro, Akash ; Ward, Chris ; Prince, H. Miles ; Zannettino, Andrew. / Bisphosphonate guidelines for treatment and prevention of myeloma bone disease. In: Internal Medicine Journal. 2017 ; Vol. 47, No. 8. pp. 938-951.
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abstract = "Multiple myeloma (MM) is a haematological malignancy characterised by the clonal proliferation of plasma cells in the bone marrow. More than 80{\%} of patients with MM 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 pathologic fracture, spinal cord compression and hypercalcaemia. MBD is the result of MM plasma cells-mediated activation of osteoclast activity and suppression of osteoblast activity. Bisphosphonates (BP), pyrophosphate analogues with high bone affinity, are the only pharmacological agents currently recommended for the treatment and prevention of MBD and remain the standard of care. Pamidronate and zoledronic acid are the most commonly used BP to treat MBD. Although generally safe, frequent high doses of BP are associated with adverse events such as renal toxicity and osteonecrosis of the jaw. As such, optimal duration and dosing of BP therapy is required in order to minimise BP-associated adverse events. The following guidelines provide currently available evidence for the adoption of a tailored approach when using BP for the management of MBD.",
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Lee, OL, Horvath, N, Lee, C, Joshua, D, Ho, J, Szer, J, Quach, H, Spencer, A, Harrison, S, Mollee, P, Roberts, AW, Talaulikar, D, Brown, R, Augustson, B, Ling, S, Jaksic, W, Gibson, J, Kalff, A, Johnston, A, Kalro, A, Ward, C, Prince, HM & Zannettino, A 2017, 'Bisphosphonate guidelines for treatment and prevention of myeloma bone disease', Internal Medicine Journal, vol. 47, no. 8, pp. 938-951. https://doi.org/10.1111/imj.13502

Bisphosphonate guidelines for treatment and prevention of myeloma bone disease. / Lee, Oi Lin; Horvath, Noemi; Lee, Cindy; Joshua, Doug; Ho, Joy; Szer, Jeff; Quach, Hang; Spencer, Andrew; Harrison, Simon; Mollee, Peter; Roberts, Andrew W.; Talaulikar, Dipti; Brown, Ross; Augustson, Bradley; Ling, Silvia; Jaksic, Wilfrid; Gibson, John; Kalff, Anna; Johnston, Anna; Kalro, Akash; Ward, Chris; Prince, H. Miles; Zannettino, Andrew.

In: Internal Medicine Journal, Vol. 47, No. 8, 01.08.2017, p. 938-951.

Research output: Contribution to journalLetter

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T1 - Bisphosphonate guidelines for treatment and prevention of myeloma bone disease

AU - Lee, Oi Lin

AU - Horvath, Noemi

AU - Lee, Cindy

AU - Joshua, Doug

AU - Ho, Joy

AU - Szer, Jeff

AU - Quach, Hang

AU - Spencer, Andrew

AU - Harrison, Simon

AU - Mollee, Peter

AU - Roberts, Andrew W.

AU - Talaulikar, Dipti

AU - Brown, Ross

AU - Augustson, Bradley

AU - Ling, Silvia

AU - Jaksic, Wilfrid

AU - Gibson, John

AU - Kalff, Anna

AU - Johnston, Anna

AU - Kalro, Akash

AU - Ward, Chris

AU - Prince, H. Miles

AU - Zannettino, Andrew

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Multiple myeloma (MM) is a haematological malignancy characterised by the clonal proliferation of plasma cells in the bone marrow. More than 80% of patients with MM 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 pathologic fracture, spinal cord compression and hypercalcaemia. MBD is the result of MM plasma cells-mediated activation of osteoclast activity and suppression of osteoblast activity. Bisphosphonates (BP), pyrophosphate analogues with high bone affinity, are the only pharmacological agents currently recommended for the treatment and prevention of MBD and remain the standard of care. Pamidronate and zoledronic acid are the most commonly used BP to treat MBD. Although generally safe, frequent high doses of BP are associated with adverse events such as renal toxicity and osteonecrosis of the jaw. As such, optimal duration and dosing of BP therapy is required in order to minimise BP-associated adverse events. The following guidelines provide currently available evidence for the adoption of a tailored approach when using BP for the management of MBD.

AB - Multiple myeloma (MM) is a haematological malignancy characterised by the clonal proliferation of plasma cells in the bone marrow. More than 80% of patients with MM 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 pathologic fracture, spinal cord compression and hypercalcaemia. MBD is the result of MM plasma cells-mediated activation of osteoclast activity and suppression of osteoblast activity. Bisphosphonates (BP), pyrophosphate analogues with high bone affinity, are the only pharmacological agents currently recommended for the treatment and prevention of MBD and remain the standard of care. Pamidronate and zoledronic acid are the most commonly used BP to treat MBD. Although generally safe, frequent high doses of BP are associated with adverse events such as renal toxicity and osteonecrosis of the jaw. As such, optimal duration and dosing of BP therapy is required in order to minimise BP-associated adverse events. The following guidelines provide currently available evidence for the adoption of a tailored approach when using BP for the management of MBD.

KW - bisphosphonate

KW - myeloma

KW - osteoblast

KW - osteoclast

KW - osteolysis

KW - skeletal-related event (SRE)

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