Are there benefits to long-term bisphosphonate treatment in multiple myeloma (MM)? Insights from temporal analyses of zoledronic acid (ZOL) versus clodronate (CLO) in the MRC Myeloma IX Trial.

Davies, FE; Morgan, Gareth J.; Wu, Pengjie; Gregory, Walter A.; Bell, SE; Szubert, AJ; Coy, Nuria Navarro; Drayson, Mark T.; Owen, RG; Feyler, Sylvia; Ashcroft, John; Ross, FM; Byrne, J L; Roddie, Huw; Rudin, C.; Cook, Guillermo; Jackson, GH; Boyd, Kevin; Child, J. Anthony

doi:10.1200/jco.2011.29.15_suppl.8011

Cited by 3 publications

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“…The reductions in SRE risk were shown regardless of bone lesions at baseline and within the first year of treatment. Furthermore, SREs continued to be decreased in the ZOL group versus the clodronate group after completing 2 years of treatment ( P = 0.0102) [21]. The clinical benefit of uninterrupted treatment with ZOL in patients with MM is evident from these data.…”

Section: Discussionmentioning

confidence: 97%

“…These benefits were observed within a few months of treatment initiation, and the differences between the two treatments continued to favor ZOL throughout the study. Moreover, ZOL significantly reduced SRE risk versus clodronate in each of the first 3 years of the study, after which time differences remained evident, although statistical power was insufficient to achieve significance [21].…”

Section: Introductionmentioning

confidence: 99%

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Persistency with zoledronic acid is associated with clinical benefit in patients with multiple myeloma

et al. 2012

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Zoledronic acid (ZOL), an intravenous bisphosphonate, has been shown to reduce and delay the incidence of skeletal‐related events (SREs) in multiple myeloma (MM) patients with bone disease. A retrospective claims‐based analysis was conducted that used two distinct US managed care databases to examine the relationship between persistency with ZOL and clinical benefit. Patients >18 years, diagnosed with MM, and with at least one claim for ZOL (or a claim for malignant bone disease and ZOL initiation within 30 days) between 1/1/2001 and 12/31/2006 were included. Patients were evaluated for incidence of SREs and for mortality. Treatment persistency was defined as the absence of a >45 day gap between ZOL administrations. Of 1,655 patients in this analysis, 1,060 received ZOL and 595 received no intravenous bisphosphonate therapy. Compared with patients not receiving bisphosphonate therapy, ZOL‐treated patients had lower incidences of SREs (P < 0.0001) and death (P = 0.0001). Longer persistency with ZOL was associated with lower risks of SREs (P = 0.001), fracture (P = 0.003), and death (P = 0.002) versus shorter persistency. Patients who were persistent with ZOL for ≥1.5 years had an incidence of 15.0 SREs and 6.2 fractures per 100 person‐years. Patients who were persistent for 31–90 days had an incidence of 24.6 SREs and 14.0 fractures per 100 person‐years, and patients not receiving intravenous bisphosphonates had an incidence of 32.2 SREs and 16.9 fractures per 100 person‐years. These data from a real‐world setting indicate that among MM patients, longer persistency with ZOL was associated with a lower risk of SREs and fracture. Am. J. Hematol. 87:490–495, 2012. © 2012 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%