The role of bone‐modifying agents in myeloma bone disease
ABSTRACT Bone disease is common in patients with multiple myeloma (MM), which manifests as bone pain and skeletal‐related events (SREs) such as pathological fractures and spinal cord compression. Myeloma bone disease (MBD) can adversely affect the quality of life of patients and have negative effect...
Main Authors: | , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Wiley
2021-08-01
|
Series: | JBMR Plus |
Subjects: | |
Online Access: | https://doi.org/10.1002/jbm4.10518 |
id |
doaj-b50a6dec73dd4ef992475e4934c3be57 |
---|---|
record_format |
Article |
spelling |
doaj-b50a6dec73dd4ef992475e4934c3be572021-08-03T00:49:59ZengWileyJBMR Plus2473-40392021-08-0158n/an/a10.1002/jbm4.10518The role of bone‐modifying agents in myeloma bone diseaseHuifang Lu0Xerxes Pundole1Hans C. Lee2Department of General Internal Medicine Section of Rheumatology and Clinical Immunology Houston Texas USADepartment of Health Services Research The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Lymphoma/Myeloma The University of Texas MD Anderson Cancer Center Houston Texas USAABSTRACT Bone disease is common in patients with multiple myeloma (MM), which manifests as bone pain and skeletal‐related events (SREs) such as pathological fractures and spinal cord compression. Myeloma bone disease (MBD) can adversely affect the quality of life of patients and have negative effects on morbidity and mortality. The pathogenesis of MBD is complex, and several factors are involved in the dysregulation of bone metabolism and uncoupling of bone remodeling, which result in net bone loss and devastating SREs. Broadly speaking, elevated osteoclast activity, suppressed osteoblast activity, and an aberrant marrow microenvironment play a role in MBD. Interaction of MM cells with the main bone cell osteocytes also promote further bone destruction. This review focuses on the role of bone‐modifying agents in the prevention and treatment of MBD. The mainstay of MBD prevention are antiresorptive agents, bisphosphonates and denosumab. However, these agents do not play a direct role in bone formation and repair of existing MBD. Newer agents with anabolic effects such as anti‐sclerostin antibodies, parathyroid hormone, anti‐Dickkopf‐1 antibodies, and others have shown potential in repair of MBD lesions. With the development of several new agents, the treatment landscape of MBD is likely to evolve in the coming years. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.https://doi.org/10.1002/jbm4.10518ANABOLICSANTIRESORPTIVESCANCEROSTEOBLASTSOSTEOCLASTS |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Huifang Lu Xerxes Pundole Hans C. Lee |
spellingShingle |
Huifang Lu Xerxes Pundole Hans C. Lee The role of bone‐modifying agents in myeloma bone disease JBMR Plus ANABOLICS ANTIRESORPTIVES CANCER OSTEOBLASTS OSTEOCLASTS |
author_facet |
Huifang Lu Xerxes Pundole Hans C. Lee |
author_sort |
Huifang Lu |
title |
The role of bone‐modifying agents in myeloma bone disease |
title_short |
The role of bone‐modifying agents in myeloma bone disease |
title_full |
The role of bone‐modifying agents in myeloma bone disease |
title_fullStr |
The role of bone‐modifying agents in myeloma bone disease |
title_full_unstemmed |
The role of bone‐modifying agents in myeloma bone disease |
title_sort |
role of bone‐modifying agents in myeloma bone disease |
publisher |
Wiley |
series |
JBMR Plus |
issn |
2473-4039 |
publishDate |
2021-08-01 |
description |
ABSTRACT Bone disease is common in patients with multiple myeloma (MM), which manifests as bone pain and skeletal‐related events (SREs) such as pathological fractures and spinal cord compression. Myeloma bone disease (MBD) can adversely affect the quality of life of patients and have negative effects on morbidity and mortality. The pathogenesis of MBD is complex, and several factors are involved in the dysregulation of bone metabolism and uncoupling of bone remodeling, which result in net bone loss and devastating SREs. Broadly speaking, elevated osteoclast activity, suppressed osteoblast activity, and an aberrant marrow microenvironment play a role in MBD. Interaction of MM cells with the main bone cell osteocytes also promote further bone destruction. This review focuses on the role of bone‐modifying agents in the prevention and treatment of MBD. The mainstay of MBD prevention are antiresorptive agents, bisphosphonates and denosumab. However, these agents do not play a direct role in bone formation and repair of existing MBD. Newer agents with anabolic effects such as anti‐sclerostin antibodies, parathyroid hormone, anti‐Dickkopf‐1 antibodies, and others have shown potential in repair of MBD lesions. With the development of several new agents, the treatment landscape of MBD is likely to evolve in the coming years. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research. |
topic |
ANABOLICS ANTIRESORPTIVES CANCER OSTEOBLASTS OSTEOCLASTS |
url |
https://doi.org/10.1002/jbm4.10518 |
work_keys_str_mv |
AT huifanglu theroleofbonemodifyingagentsinmyelomabonedisease AT xerxespundole theroleofbonemodifyingagentsinmyelomabonedisease AT hansclee theroleofbonemodifyingagentsinmyelomabonedisease AT huifanglu roleofbonemodifyingagentsinmyelomabonedisease AT xerxespundole roleofbonemodifyingagentsinmyelomabonedisease AT hansclee roleofbonemodifyingagentsinmyelomabonedisease |
_version_ |
1721224615628374016 |