Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Cochrane on Bisphosphonates in Multiple Myeloma

Cochrane; 2017 Dec 18; Mhaskar, Kumar, et al

Bisphosphonates in patients with multiple myeloma (MM) reduces pathological vertebral fractures, skeletal-related events, and pain, according to a Cochrane review of 24 trials involving nearly 7,300 participants. Among the findings:

  • Bisphosphonates did not improve overall or disease progression-free survival.
  • They reduced overall fractures and fractures of the vertebra, but not non-vertebral fractures.
  • They alleviated pain, with osteonecrosis the only major adverse event (event rate of 1/1,000 patients treated).
  • Zoledronate was more efficacious than than etidronate and placebo, but it did not improve overall survival or other outcomes better than pamidronate or clodronate.
  • No specific aminobisphosphonate or non-aminobisphosphonate was found to be superior for any outcome.


Mhaskar R, Kumar A, Miladinovic B, Djulbegovic B. Bisphosphonates in multiple myeloma: An updated network meta-analysis. Cochrane Database of Systematic Reviews. 2017, Issue 12. Art. No.: CD003188. doi:10.1002/14651858.CD003188.pub4

This Week's Must Reads

Transfusions don't factor in rheumatoid arthritis transmission, Just SA et al. Ann Rheum Dis. 2018 Mar 1. doi: 10.1136/annrheumdis-2017-212844.

Ibrutinib and infection risk, Ghez D et al. Blood. 2018 Feb 1. doi: 10.1182/blood-2017-11-818286.

Mortality after transplant for hemoglobinopathies, Broglie L et al. BMT Tandem Meeting, Abstract 16.

Shingrix safe in post-transplant patients, Source: de la Serna J et al. 2018 BMT Tandem Meetings, Abstract LBA2

Over half of refractory AML patients responded to combo, Advani A et al. ASH 2017, Abstract 150.

Must Reads in Multiple Myeloma

Cochrane on Bisphosphonates in Multiple Myeloma, Cochrane; 2017 Dec 18; Mhaskar, Kumar, et al

VDT PACE-Like Therapy for Relapsed/Refractory MM, Am J Hematol; ePub 2017 Nov 10; Lakshman, et al

Auto/Allo and Tandem Auto HCT for MM Compared, Biol Blood Marrow Transplant; ePub 2017 Oct 25; Htut, et al

Index Can Predict Survival in Patients with MM, Clin Lymphoma Myeloma Leuk; ePub 2017 Sep 19; Ely, et al

Economic Burden of Multiple Myeloma Evaluated, Leuk Lymphoma; ePub 2017 Aug 13; MacEwan, et al