Bone protection treatment in multiple myeloma

This study examined the use of bisphosphonate treatment for bone protection in patients with multiple myeloma. This study concluded that many patients do not receive adequate bone protection.

In multiple myeloma, bones are commonly affected, leading to bone destruction. Bisphosphonates are a group of drugs that prevent bone loss. They are the standard recommendation for treating bone disease in patients with multiple myeloma. Studies have shown that bisphosphonates reduce the occurrence of bone problems like fractures. However, it is not clear as to how long bisphosphonates should be given and when the dose should be reduced. This is important as one side effect of bisphosphonates is that they affect kidney function.

11,112 patients with multiple myeloma were included. Patients were followed for an average 818 days. 63% of patients received bisphosphonate during the follow-up period. 6180 patients received zoledronic acid (Zometa) only and 489 received pamidronate (Aredia) only.

There was an average of 106 days from the day of diagnosis to the day of first bisphosphonate treatment. The average duration of bisphosphonate treatment was 498 days. Of patients who started bisphosphonates, 58% started it within the first year of diagnosis. The average number of doses given in the first year was 6.8.

82% of patients who received bisphosphonate either stopped or changed dose at least once during the study period. Of these patients, 62% stopped treatment. The average duration of treatment for patients who stopped treatment was 318 days.

46.3% of patients had impaired kidney function. Patients with worse kidney function at the start of the study were less likely to receive bisphosphonates. Patients with worse kidney function were more likely to have a delay in receiving bisphosphonate treatment than patients with better kidney function.

The authors concluded that patients with multiple myeloma may not receive optimal treatment for bone disease, especially those with impaired kidney function.

Talk to your doctor about your need for bone protection therapy.