Denosumab has shown to be noninferior to zoledronic acid for the prevention of skeletal-related events and provides an alternative .
Fewer adverse events related to renal toxicity have been noted with denosumab compared with zoledronic acid and may be preferred in this setting .
Purpose To up date guideline recommendations on the role of bone-modifying agents in multiple myeloma .
Zoledronic Acid Markedly Improves Bone Mineral Density for Patients with Monoclonal Gammopathy of Undetermined Significance and Bone Loss
Purpose : Patients with monoclonal gammopathy of undetermined significance ( MGUS ) have increased rates of bone resorption , osteopenia , osteoporosis , and risk of fractures . This study was undertaken to determine the efficacy and safety of zoledronic acid for patients with MGUS and enhanced bone loss . Experimental Design : In this phase II open-label study , 54 patients with MGUS and osteopenia or osteoporosis were administered zoledronic acid 4 mg i.v . at 0 , 6 , and 12 months . The primary efficacy end point was bone mineral density , assessed using a dual-energy X-ray absorptiometry scan in the lumbar (L)-spine done at screening and at 13 months ( 1 month after the final zoledronic acid infusion ) . Results : At study end for all patients ( N = 54 ) , L-spine T-scores improved by a median of + 0.27 ( range , −0.38 to + 3.91 ) , corresponding to a median increase in bone mineral density of + 15.0 % ( range , −18.0 % to + 1,140.0 % ; P < 0.0001 ) . Hip T-scores improved by a median of + 0.10 ( range , −2.40 to + 2.03 ) , corresponding to a median increase of + 6.0 % ( range , −350.0 % to + 165.0 % ) . During the study , no new fractures , osteonecrosis of the jaw , or significant renal adverse events were reported . Conclusions : Zoledronic acid administered i.v . at a dosage of 4 mg every 6 months for three doses total was well-tolerated and substantially improved bone mineral density for patients with MGUS and bone loss .  Zoledronic acid may be effective for the prevention of new fractures in this high-risk population
Denosumab has shown to be noninferior to zoledronic acid for the prevention of skeletal-related events and provides an alternative .
Fewer adverse events related to renal toxicity have been noted with denosumab compared with zoledronic acid and may be preferred in this setting .
Purpose To up date guideline recommendations on the role of bone-modifying agents in multiple myeloma .