Management of bone disease in multiple myeloma

Evangelos Terpos, James Berenson, Noopur Raje, G. David Roodman

Research output: Contribution to journalReview article

56 Scopus citations


Osteolytic bone disease is the most common complication of multiple myeloma, resulting in skeletal complications that cause significant morbidity and mortality. Currently, bisphosphonates (BPs) are the mainstay for the treatment of myeloma bone disease. Zoledronic acid which has been found to be superior to clodronate, both in terms of reduction of skeletal-related events (SREs) and survival, and pamidronate are used for the management of myeloma-related bone disease. Patients with active disease (not in CR or VGPR) should receive BPs (especially zoledronic acid) even after two years of administration. Radiotherapy and surgical interventions can also be used for specific conditions, such as pathological fractures, spinal cord compression or uncontrolled pain. The better understanding of the biology of myeloma bone disease has led to the production of several novel agents, such as denosumab (targeting RANKL), sotatercept (activin-A antagonist) and romosozumab (targeting sclerostin) that appear very promising and have entered to clinical development.

Original languageEnglish (US)
Pages (from-to)113-125
Number of pages13
JournalExpert Review of Hematology
Issue number1
StatePublished - Feb 1 2014


  • activin-A
  • bisphosphonates
  • bone disease
  • denosumab
  • sclerostin
  • sotatercept
  • Wnt pathway

ASJC Scopus subject areas

  • Hematology

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