[Skip to Content]
[Skip to Content Landing]
Views 752
Citations 0
Research Letter
December 12, 2019

Use of Bone-Modifying Agents Among Medicare Beneficiaries With Multiple Myeloma

Author Affiliations
  • 1The Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
  • 2Division of Surgical Oncology, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 3Division of Hematology, Mayo Clinic, Rochester, Minnesota
  • 4Division of Cancer Care and Epidemiology, Department of Oncology, Queen's University, Kingston, Ontario, Canada
  • 5Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
  • 6Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
JAMA Oncol. Published online December 12, 2019. doi:10.1001/jamaoncol.2019.5426

The US Food and Drug Administration (FDA) approved denosumab to prevent skeletal-related events in patients with multiple myeloma on January 5, 2018, based on the results of a noninferiority trial.1 However, denosumab requires a more frequent dosing schedule and is much more expensive than standard bisphosphonate therapy.2 Denosumab discontinuation is associated with rapid bone loss, and patients who discontinue denosumab therapy will likely require subsequent treatment with bisphosphonates to limit anticipated bone loss.2,3 Therefore, its routine use is difficult to justify except in patients with renal dysfunction or in those unable to tolerate bisphosphonates. In light of these issues, we describe the uptake in use of denosumab after FDA approval.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words