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.
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Gupta A, Wang P, Ali SA, et al. Use of Bone-Modifying Agents Among Medicare Beneficiaries With Multiple Myeloma. JAMA Oncol. Published online December 12, 2019. doi:10.1001/jamaoncol.2019.5426
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