Bisphosphonates in multiple myeloma

Randomized Clinical Trial of Zoledronic Acid in Multiple Myeloma Patients Undergoing High-Dose Chemotherapy and Stem-Cell Transplantation

“…In symptomatic previously untreated multiple myeloma patients, zol combined with high-dose therapy followed by asct improved os and pfs without whether bone lesions have been detected, and in this setting, zol is the bisphosphonate of choice 5,[7][8][9] . In addition to its bone-protective effects, zol has demonstrated clinically meaningful anticancer activity in multiple cancer settings, including that of multiple myeloma [10][11][12][13][14][15] .…”

“…Until recently, there was no consensus as to which bisphosphonate is superior at improving disease outcomes. However, emerging prospective clinical data now favour zol over other approved bisphosphonates for this purpose 9,15,46 . In the mrc Myeloma ix trial, zol was superior to clodronate in newly diagnosed multiple myeloma patients for several endpoints 15,46 .…”

Cost-Effectiveness of Zoledronic Acid Compared with Clodronate in Multiple Myeloma

“…If the threshold icer is CA$100,000 per qaly, the estimated probability that zoledronic acid is where sres are typically defined as hypercalcemia, pathologic fracture, spinal cord compression, and radiotherapy to bone 2 . Several bisphosphonates have also demonstrated anticancer activity in preclinical models [3][4][5][6][7][8] .…”

“…Although intravenous pamidronate is used as bisphosphonate therapy in many settings, controlled clinical trials of zoledronic acid compared with pamidronate or of clodronate compared with pamidronate in patients with multiple myeloma that report information on pfs and os are unavailable 2 . A comparison of the cost-effectiveness of zoledronic acid and clodronate with that of pamidronate in this indication therefore would require an adjusted indirect comparison using information from controlled trials of pamidronate compared with placebo 10,11 and of clodronate compared with placebo 40,41 in multiple myeloma patients.…”

CYP2C8 gene polymorphism and bisphosphonate-related osteonecrosis of the jaw in patients with multiple myeloma

“…2 Although ONJ has been described during therapy with any BP, the possibility of developing ONJ may increase with the use of the more potent BPs, with a higher incidence for zoledronic acid (ZOL). [6][7][8] Recently, several guidelines for the prevention, diagnosis, and management of ONJ have been released. These mainly focus on the relevant clinical aspects of prevention.…”