Clin Osteol 2017; 22(1): 19-31

Diagnosis and treatment of bone disease in multiple myeloma; II. Treatment of myeloma bone disease in clinical practiceOriginal contributions

V. Ščudla, J. Minařík, T. Pika, P. Krhovská, J. Bačovský

Presented is a current view of the available and prospective possibilities of treating myeloma bone disease (MBD) in cli­ nical practice with emphasis on the key benefit of intravenous therapy with amino-bisphosphonates (BPNs), in particular zoledronic acid (ZA) or pamidronate, in the prevention and treatment of bone-destructive skeletal involveme ple myeloma (MM). Presented are the International Myeloma Working Group and European Myeloma Network guide­ lines summarizing the recent principles of the rational use of BFN, focal radiotherapy, balloon kyphoplasty and surgical treatment which, together with effective anti-MM therapy, reduce bone pain, limit further progression of the osteolytic process in MM and the development of pathological fractures, the development of hypercalcemia, improve the quality of life and, in case of ZA therapy, the overall survival. Also outlined are the possibilities of prospective ta therapy stemming from deeper understanding of the pathophysiology of MBD and using preparations regulating bone remodeling processes by inhibiting osteoclast resorption and/or promoting osteoblast bone formation, e.g. proteasome inhibitors (bortezomib), RANKL inhibitors (denosumab), activin A inhibitors (sotatercept) and a MoAb against sclerostin (romosozumab), DKK-1, and numerous other tested substances that, mainly in combination with BPNs to supplement anti-MM therapy, hold great promise for the future regarding advances in the tr

Keywords: myeloma bone disease, therapy, bisphosphonates, denosumab, bortezomib

Published: June 11, 2017  Show citation

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Ščudla V, Minařík J, Pika T, Krhovská P, Bačovský J. Diagnosis and treatment of bone disease in multiple myeloma; II. Treatment of myeloma bone disease in clinical practice. Osteologický bulletin. 2017;22(1):19-31.
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