Contributions
Abstract: PB2218
Type: Publication Only
Background
Bisphosphonates are specific inhibitors of osteoclastic activity and form a cornerstone in the treatment of Patients with multiple myeloma to reduce the incidence of Skeletal related events. They are shown to be effective in reducing the incidence of Pathological fractures and pain.Skletal related events in multiple myeloma patients are associated with adverse outcomes in the form of increased morbidity, more hospital admissions and poor quality of life.We conducted a retrospective audit of bisphosphonates use in multiple myeloma patients in two district general hospitals against the UK NICE guidelines.
NICE published guidelines in February, 2016 regarding management of Multiple Myeloma Patients, recommending the use of Intravenous bisphosphonates in all multiple myeloma patients soon after diagnosis
Aims
Our Primary objectives were:
1: To assess our compliance with the NICE guideline,
2: To assess the efficacy of I/V Bisphosphonates in reducing the incidence of Pathological fractures in multiple myeloma patients.
Our secondary objective was to assess the incidence of osteonecrosis of Jaw in patients receiving I/V Bisphosphonates.
Methods
We collected the data for newly diagnosed multiple myeloma patients between January, 2010 to December, 2017 at the Hillingdon and west Middlesex hospiatals from the clinic letters, medical notes and radiology reports.
Results
There were 110 patient diagnosed with multiuple myeloma during this period . 102 (92.7%) of the patients received I/V bisphosphonates, out of these 62 pateints received Zolendronic acid and 40 patients received Pamidronate.Only 8(7.2%) Patients did not receive Bisphosphonates, 2 of these patients were intolerant of the treatment, for the rest of the 6 patients no reason was identified from the medical notes.Mean Duration of treatment was 24 months(range 12-36 months),56(50%) of the patients had pathological fractures at the time of Diagnoses.Only 16(14%) of the patients receiving bisphosphonates were found to have a new pathological fracture.On the other hand the incidence of pathological fracture was much higher in patients who did not receive any bisphosphonate, 3 (37.5%) patients not recieving bisphosphonates were found to have a new pathological fracture.None of the patients treated with I/V bisphosphonates were found to have osteonecrosis of jaw.
Conclusion
Although our data is relatively small but clearly demonstrates ,
-Our compliance with NICE guidelines regarding the use of I/V Bisphosphonates in multiple myeloma patients,
-Reduction in the incidence of Pathological fractures in multiple myeloma patients receiving bisphonates( 14% vs 37.5% in treated and untreated groups respectively),
-none of the patients were identified to have developed osteonecrosis of jaw with I/V bisphonate treatment, (International consensus is 1 in 1000 patient being treated with I/V Bisphosphonates will develop osteonecrosis of jaw).
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Multiple Myeloma, Bisphosphonate
Abstract: PB2218
Type: Publication Only
Background
Bisphosphonates are specific inhibitors of osteoclastic activity and form a cornerstone in the treatment of Patients with multiple myeloma to reduce the incidence of Skeletal related events. They are shown to be effective in reducing the incidence of Pathological fractures and pain.Skletal related events in multiple myeloma patients are associated with adverse outcomes in the form of increased morbidity, more hospital admissions and poor quality of life.We conducted a retrospective audit of bisphosphonates use in multiple myeloma patients in two district general hospitals against the UK NICE guidelines.
NICE published guidelines in February, 2016 regarding management of Multiple Myeloma Patients, recommending the use of Intravenous bisphosphonates in all multiple myeloma patients soon after diagnosis
Aims
Our Primary objectives were:
1: To assess our compliance with the NICE guideline,
2: To assess the efficacy of I/V Bisphosphonates in reducing the incidence of Pathological fractures in multiple myeloma patients.
Our secondary objective was to assess the incidence of osteonecrosis of Jaw in patients receiving I/V Bisphosphonates.
Methods
We collected the data for newly diagnosed multiple myeloma patients between January, 2010 to December, 2017 at the Hillingdon and west Middlesex hospiatals from the clinic letters, medical notes and radiology reports.
Results
There were 110 patient diagnosed with multiuple myeloma during this period . 102 (92.7%) of the patients received I/V bisphosphonates, out of these 62 pateints received Zolendronic acid and 40 patients received Pamidronate.Only 8(7.2%) Patients did not receive Bisphosphonates, 2 of these patients were intolerant of the treatment, for the rest of the 6 patients no reason was identified from the medical notes.Mean Duration of treatment was 24 months(range 12-36 months),56(50%) of the patients had pathological fractures at the time of Diagnoses.Only 16(14%) of the patients receiving bisphosphonates were found to have a new pathological fracture.On the other hand the incidence of pathological fracture was much higher in patients who did not receive any bisphosphonate, 3 (37.5%) patients not recieving bisphosphonates were found to have a new pathological fracture.None of the patients treated with I/V bisphosphonates were found to have osteonecrosis of jaw.
Conclusion
Although our data is relatively small but clearly demonstrates ,
-Our compliance with NICE guidelines regarding the use of I/V Bisphosphonates in multiple myeloma patients,
-Reduction in the incidence of Pathological fractures in multiple myeloma patients receiving bisphonates( 14% vs 37.5% in treated and untreated groups respectively),
-none of the patients were identified to have developed osteonecrosis of jaw with I/V bisphonate treatment, (International consensus is 1 in 1000 patient being treated with I/V Bisphosphonates will develop osteonecrosis of jaw).
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Multiple Myeloma, Bisphosphonate