In a nutshell
This paper studied the use of bone targeting agents in patients with multiple myeloma. The authors concluded that there could be insufficient bone targeted treatment in patients with multiple myeloma.
Some background
Multiple myeloma is a cancer of the plasma cells (type of white blood cell). This causes bone destruction, high levels of calcium in the blood, and kidney failure. About 67% of newly diagnosed patients have bone lesions. Bony lesions increase the risk of fractures and spinal cord compression. Thus, bone-targeted agents are used to manage bone disease in patients with multiple myeloma. Examples of bone-targeted agents include bisphosphonates such as zoledronic acid (Zometa) and pamidronate (Aredia). There has been limited studies on the use of bone-targeted agents in patients with multiple myeloma.
Methods & findings
Among 9617 patients with multiple myeloma, 38.8% of patients received bone-targeted agents. Of these, 90.9% of patients were treated with zoledronic acid and 9.1% of patients were treated with pamidronate. 75.1% of patients who received zoledronic acid and 76.1% of patients who received pamidronate had been started on bone treatment within 3 months of their diagnosis.
In year 1, 27.4% of patients who received zoledronic acid and 23% of those treated with pamidronate had 12 or more administrations a year. In year 2, the rate fell to 19.8% in patients who received zoledronic acid and 15.6% in patients who received pamidronate.
Persistence rates (no change of drug and less than 90 days gap without treatment) declined over time. For patients on zoledronic acid, persistence rate dropped from 86% at 6 months to 34% at 24 months. For patients on pamidronate, the persistence rate dropped from 77% at 6 months to 30% at 24 months. A greater proportion of patients who received pamidronate switched to zoledronic acid.
The bottom line
The authors concluded that there could be insufficient bone targeted treatment in patients with multiple myeloma.
What’s next?
Talk to your doctor about your need for bone-targeted agents.
Published By :
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Date :
Oct 23, 2017
