Myeloma Bone Disease: Update on Pathogenesis and Novel Treatment Strategies

Pharmaceutics - Tập 10 Số 4 - Trang 202
Sonia Vallet1, Julia-Marie Filzmoser2, Martin Pecherstorfer3, Klaus Podar4
1Department of Internal Medicine, Karl Landsteiner University of Health Sciences, University Hospital, 3500 Krems an der Donau, Austria. [email protected].
2Karl Landsteiner University of Health Sciences, 3500 Krems an der Donau, Austria. [email protected].
3Department of Internal Medicine, Karl Landsteiner University of Health Sciences, University Hospital, 3500 Krems an der Donau, Austria. [email protected].
4Department of Internal Medicine, Karl Landsteiner University of Health Sciences, University Hospital, 3500 Krems an der Donau, Austria. [email protected].

Tóm tắt

Bone disease, including osteolytic lesions and/or osteoporosis, is a common feature of multiple myeloma (MM). The consequences of skeletal involvement are severe pain, spinal cord compressions, and bone fractures, which have a dramatic impact on patients’ quality of life and, ultimately, survival. During the past few years, several landmark studies significantly enhanced our insight into MM bone disease (MBD) by identifying molecular mechanisms leading to increased bone resorption due to osteoclast activation, and decreased bone formation by osteoblast inhibition. Bisphosphonates were the mainstay to prevent skeletal-related events in MM for almost two decades. Excitingly, the most recent approval of the receptor activator of NF-kappa B ligand (RANKL) inhibitor, denosumab, expanded treatment options for MBD, for patients with compromised renal function, in particular. In addition, several other bone-targeting agents, including bone anabolic drugs, are currently in preclinical and early clinical assessment. This review summarizes our up-to-date knowledge on the pathogenesis of MBD and discusses novel state-of-the-art treatment strategies that are likely to enter clinical practice in the near future.

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