I have been getting e-mails aking about bisphosphonates lately. Recommended frequency and duration come up most often. I’m not a doctor. But the trend has been to stop using Aredia or Zometa sooner rather than later. How about dosing every three weeks rather than monthly? If you doctor thinks it is a good idea, why not? Just not for an indefinite amount of time. Here is an article I wrote on the subject after discussing Aredia with the International Myeloma Foundation’s (IMF) Medical Director Dr. Brian Durie last September:
During our interview at the end of July, Dr. Brian Durie stressed the benefits of using Aredia (his bisphosphonate of choice) or Zometa to treat multiple myeloma. These drugs not only help strenghten and repair damaged bones, they can also reduce the size and number of lesions and help reduce the number of myeloma cells in the bone marrow as well, especially when used in combination with Velcade, Revlimid or Thalidomide.
How long should you use bisphosphonates? Monthly for the first two years after diagnosis if active bone disease is present. After that, every three months in patients with severe bone damage. Start using the drugs again if and when new disease is detected.
There has been much written about the risk of side effects, such as osteonecrosis of the jaw, while using these drugs. I won’t belabor that here. But there is a higher risk of developing osteonecrosis while using Zometa. Longer and slower IV administration of the drug can reduce those risks. Both drugs also increase the risk of renal toxicitiy. But all myeloma specialists present agreed the rewards far out way the risks, especially if use is reduced or stopped after two years. The new drug, Denusomab, apparently is more effective and will have fewer side effects. It should be available for general use within two years.
Feel good, keep smiling and take your vitamin D and calcium daily! Pat