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Prashant Kapoor, MD, FACP


ASCO Quality 2023: Antiresorptive Therapy and Myeloma-Related Skeletal Disease

By: Celeste L. Dixon
Posted: Tuesday, October 31, 2023

Results of work presented at the 2023 American Society of Clinical Oncology (ASCO) Quality Care Symposium (Abstract 398) indicate that antiresorptive therapy for patients with myeloma-related skeletal disease seems to be significantly underprescribed. Many delays occur in initiating therapy, and some patients with such osseous disease may never be started on such treatment despite best practice recommendations, according to Amman Bhasin, MD, of Thomas Jefferson University Hospital, Philadelphia, and colleagues.

In the team’s sample of 68 patients newly diagnosed with multiple myeloma in 2022 at their institution, 39 (57.4%) had lytic lesions on imaging; 23 of these patients (59%) were prescribed antiresorptive therapy. The median time from diagnosis of multiple myeloma to antiresorptive prescription was 18 days for a bisphosphonate and 57 days for the monoclonal antibody denosumab.

“For those who did receive antiresorptive therapy, median time to prescription by insurance type, in days, was 23.5 for state, 36 for private, 48 for traditional Medicare, 144.5 for Medicaid expansion, and 175 for Medicare advantage,” noted Dr. Bhasin and co-investigators. Technically, with the comparison yielding a P value of .21, insurance type did not seem to factor significantly in the time-to-prescription disparities in this sample (nor did race or sex). Still, the authors stated, this “large variation in time to therapy based on insurance type warrants further investigation in a larger cohort of patients to better understand how it might lead to disparities in care.” Other potential factors should be evaluated as well, they added.

Disclosure: Dr. Bhasin reported no conflicts of interest. For full disclosures of the other study authors, visit

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