TY - JOUR TI - Management of bone disease in multiple myeloma AU - Terpos, E. AU - Berenson, J. AU - Raje, N. AU - Roodman, G.D. JO - Expert Review of Hematology PY - 2014 VL - 7 TODO - 1 SP - 113-125 PB - SN - 1747-4086, 1747-4094 TODO - 10.1586/17474086.2013.874943 TODO - bisphosphonic acid derivative; clodronic acid; denosumab; immunomodulating agent; pamidronic acid; proteasome inhibitor; romosozumab; sclerostin; sotatercept; zoledronic acid, bone disease; human; kyphoplasty; multiple myeloma; osteoclast; pain; pathologic fracture; percutaneous vertebroplasty; priority journal; review; spinal cord compression; Wnt signaling pathway, Antibodies, Monoclonal; Bone Diseases; Diphosphonates; Histone Deacetylase Inhibitors; Humans; Immunologic Factors; Kyphoplasty; Multiple Myeloma; Protease Inhibitors; Recombinant Fusion Proteins TODO - Osteolytic bone disease is the most common complication of multiple myeloma, resulting in skeletal complications that cause significant morbidity and mortality. Currently, bisphosphonates (BPs) are the mainstay for the treatment of myeloma bone disease. Zoledronic acid which has been found to be superior to clodronate, both in terms of reduction of skeletal-related events (SREs) and survival, and pamidronate are used for the management of myeloma-related bone disease. Patients with active disease (not in CR or VGPR) should receive BPs (especially zoledronic acid) even after two years of administration. Radiotherapy and surgical interventions can also be used for specific conditions, such as pathological fractures, spinal cord compression or uncontrolled pain. The better understanding of the biology of myeloma bone disease has led to the production of several novel agents, such as denosumab (targeting RANKL), sotatercept (activin-A antagonist) and romosozumab (targeting sclerostin) that appear very promising and have entered to clinical development. © Informa UK, Ltd. ER -