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Denosumab vs. Zoledronic Acid in Myeloma-Related Bone Disease

By: Cordi Craig
Posted: Thursday, August 31, 2017

Research findings suggest the human monoclonal antibody denosumab may be used in place of the bisphosphonate zoledronic acid to protect against bone-related effects in patients with multiple myeloma. In a noninferiority trial of more than 1,000 patients with newly diagnosed myeloma, denosumab showed bone-specific benefits and significantly lower risks of renal adverse events than zoledronic acid, the current standard. Evangelos Terpos, MD, of the University of Athens School of Medicine in Greece, presented these findings at the 2017 European Hematology Association (EHA) Congress in Madrid (Abstract S782).

“We found the bone-specific benefits and observed prolongation of progression-free survival, in combination with a better renal toxicity profile, provide denosumab the potential to be the new standard of care for multiple myeloma–related bone disease,” Dr. Terpos revealed in a recent interview. He noted that unlike denosumab, zoledronic acid requires dose adjustments according to a patient’s creatinine clearance and cannot be used on patients with a creatinine clearance below 30 mL/min. Denosumab does not require dose adjustments and provides the opportunity to avoid renal complications.

After a post-hoc analysis at 15 months, denosumab showed noninferiority compared with zoledronic acid in terms of the time to the first skeletal-related event. The investigators also noted no significant differences in terms of overall survival (14% in denosumab group and 15% in zoledronic acid group) or frequency of adverse events.