New agents in the Treatment of Myeloma Bone Disease

Calcified Tissue International
Elizabeth S RingAndrew D Chantry

Abstract

Patients with multiple myeloma develop a devastating bone disease driven by the uncoupling of bone remodelling, excess osteoclastic bone resorption and diminished osteoblastic bone formation. The bone phenotype is typified by focal osteolytic lesions leading to pathological fractures, hypercalcaemia and other catastrophic bone events such as spinal cord compression. This causes bone pain, impaired functional status, decreased quality of life and increased mortality. Early in the disease, malignant plasma cells occupy a niche environment that encompasses their interaction with other key cellular components of the bone marrow microenvironment. Through these interactions, osteoclast-activating factors and osteoblast inhibitory factors are produced, which together uncouple the dynamic process of bone remodelling, leading to net bone loss and focal osteolytic lesions. Current management includes antiresorptive therapies, i.e. bisphosphonates, palliative support and orthopaedic interventions. Bisphosphonates are the mainstay of treatment for myeloma bone disease (MBD), but are only partially effective and do have some significant disadvantages; for example, they do not lead to the repair of existing bone destruction. Thus, newer agen...Continue Reading

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Citations

Jan 18, 2018·Calcified Tissue International·Aymen I Idris
Oct 28, 2019·Current Opinion in Supportive and Palliative Care·Matthew Philip DaviesAndrew Chantry
Aug 24, 2019·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Alanna C GreenAndrew D Chantry
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Aug 10, 2021·JBMR Plus·Huifang LuHans C Lee
Jan 7, 2022·Clinical and Experimental Medicine·Xiangjun ShiXinru Du

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Clinical Trials Mentioned

NCT00330759
NCT01337752
NCT01562405
NCT02384083
NCT02336815

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