Should All Myeloma Patients Be on Bisphosphonates?

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Topics include: Treatments

Bisphosphonate drugs can help prevent bone loss and are an important part of myeloma therapy.  At a recent myeloma town meeting, Dr. Gareth Morgan from the University of Arkansas Medical Sciences explains the role of bisphosphonate drugs in the treatment of myeloma.  He shares his thoughts on the effectiveness of this class of drugs and dispels a myth.

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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Jack Aiello:

Should all myeloma patients be on bisphosphonates?

Dr. Morgan:

So that’s a really important question. So, bone disease and bone health is critical to myeloma patients and you should do everything you can to maintain your bone health. It can be a source of a lot of morbidity, back pain, all of those issues, fractures and so always think about your bones.

And then the question is, what’s the best approach to reducing your bone damage long term? Well, clearly getting your myeloma treated appropriately is the right thing to do. Some of the drugs that we use actually enhance the growth of your bone and prevent it being eaten away. 

But perhaps the most easy thing that can be done is to receive one of these bisphosphonate drugs. And the one that’s being the most extensively looked at is called zoledronic acid (Zometa®), and it’s a minor bisphosphonate—whatever that means, but it means it’s done good.

Minor bisphosphonates seem to be good, and they go to the bone where they’re concentrated. They kill myeloma cells and also kill the cells that resolve the bone. So they make your bones a lot stronger.

And so long term, I would say every patient should be on a bisphosphonate drug, certainly when you’ve got active disease and you’re having treatment, when you’re on steroids, the bisphosphonate drugs really work well. And there’s some evidence that we produce that they can improve survival.

So they’re actively anti-myeloma as well as anti-, as improving your bone health. So good drugs, should be on them. There was a big scare about osteonecrosis of the jaw, and, you know, it was said that 10 percent of people could have abscesses in their jaw if you had a bisphosphonate. It turns out that that was not the case. About 1 to 4 percent of people can develop that osteonecrosis. It’s important that you look after your dental care when you’re on a bisphosphonate. Overall, the balance strongly favors having a bisphosphonate rather than not having one.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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Page last updated on October 22, 2015