Clinical Question
Among patients with multiple myeloma, is bisphosphonate therapy associated with lower rates of mortality, vertebral fractures, nonvertebral fractures, and skeletal-related events compared with placebo or no treatment?
Bottom Line
Among patients with myeloma, bisphosphonates were associated with lower rates of pathological fractures and skeletal-related events compared with placebo or no treatment. Direct meta-analysis showed no association between bisphosphonates and mortality. In network meta-analysis, zoledronate was associated with lower risk of mortality compared with placebo or no treatment.
Introduction
This JAMA Clinical Evidence Synopsis summarizes a Cochrane review1 of the associations of specific bisphosphonates with mortality, vertebral and nonvertebral fractures, and overall skeletal-related events in the management of patients with myeloma.