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 as compared with observation in multiple myeloma patients at biochemical relapse: results of the randomized AZABACHE Spanish trial
This study analyzed the anti-myeloma effect of zoledronic acid monotherapy by investigating patients at the time of asymptomatic biochemical relapse . One hundred patients were r and omized to receive either zoledronic acid ( 4 mg iv/4 weeks , 12 doses ) ( n=51 ) or not ( n=49 ) . Experimental and control groups were well balanced for disease and prognostic features . Zoledronic acid did not show an antitumor effect according to changes in M-component . However , there were fewer symptomatic progressions in the experimental group than in the control group ( 34 versus 41 , respectively ; P=0.05 ) result ing in a median time to symptoms of 16 versus 10 months ( P=0.161 ) . The median time to next therapy was also slightly longer for the treated group than the untreated , control group ( 13.4 versus 10.1 months ) , although the difference was not statistically significant ( P=0.360 ) . The pattern of relapses was different for treated versus control patients : progressive bone disease ( 8 versus 20 ) , anemia ( 24 versus 18 ) , renal dysfunction ( 1 versus 2 ) , and plasmacytomas ( 1 versus 1 , respectively ) . This concurred with fewer skeletal-related events in the treated group than in the control group ( 2 versus 14 ) , with a projected 4-year event proportion of 6 % versus 40 % ( P<0.001 ) . In summary , zoledronic acid monotherapy does not show an antitumor effect on biochemical relapses in multiple myeloma , but does reduce the risk of progression with symptomatic bone disease and skeletal complications . This trial was registered in the Clinical Trials.gov data base with code
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 .