Mayo clinic consensus statement for the use of bisphosphonates in multiple myeloma.

Mayo Clin Proc 2006 Aug;81(8):1047-53

Division of Hematology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905, USA.

Bisphosphonates are effective in the prevention and treatment of bone disease in multiple myeloma (MM). Osteonecrosis of the jaw is Increasingly recognized as a serious complication of long-term bisphosphonate therapy. Issues such as the choice of bisphosphonate and duration of therapy have become the subject of intense debate given patient safety concerns. We reviewed available data concerning the use of bisphosphonates in MM. Guidelines for the use of bisphosphonates in MM were developed by a multidisciplinary panel consisting of hematologists, dental specialists, and nurses specializing in the treatment of MM. We conclude that intravenous pamidronate and intravenous zoledronic acid are equally effective and superior to placebo in reducing skeletal complications. Pamidronate is favored over zoledronic acid until more data are available on the risk of complications (osteonecrosis of the jaw). We recommend discontinuing bisphosphonates after 2 years of therapy for patients who achieve complete response and/or plateau phase. For patients whose disease is active, who have not achieved a response, or who have threatening bone disease beyond 2 years, therapy can be decreased to every 3 months. These guidelines were developed in the Interest of patient safety and will be reexamined as new data emerge regarding risks and benefits.

Download full-text PDF

Source
http://dx.doi.org/10.4065/81.8.1047DOI Listing
August 2006
7 Reads

Publication Analysis

Top Keywords

multiple myeloma
8
bone disease
8
years therapy
8
patient safety
8
zoledronic acid
8
osteonecrosis jaw
8
bisphosphonates
5
favored zoledronic
4
bisphosphonates developed
4
guidelines bisphosphonates
4
developed multidisciplinary
4
acid data
4
multidisciplinary panel
4
disease years
4
panel consisting
4
pamidronate favored
4
bisphosphonates guidelines
4
therapy decreased
4
complete response
4
guidelines developed
4

Similar Publications