[Babs]

Pamidronate (Aredia) - no benefit after 2 yrs?

by Babs on Thu Oct 31, 2013 2:53 pm

After 2 years my spouse was taken off pamidronate [Aredia]. Six months later he developed lumbar vertebral pain, was treated with radiation and started on Revlimid/dexamethasone. He was also restarted on monthly pamidronate. At a recent myeloma presentation a doctor said that there is no benefit to pamidronate after 2 years. Comments?

[Eric Hofacket]

Re: Pamidronate (Aredia) - no benefit after 2 yrs?

by Eric Hofacket on Thu Oct 31, 2013 3:52 pm

I have been on Aredia for over 2 years as well. I have not heard any studies about it being ineffective. It is my understanding though that the way these drugs work is they do not promote the growth of new bone by stimulating the activity of the osteoblast cells which are responsible for bone growth, but they inhibit the activity of the osteoclast cells that break down old bone tissue.

If the normal mechanism for promoting bone growth is not working, then at best these drugs will only help stop the normal destruction of older bone tissue, not heal or promote growth of new tissue.

I remember reading that for some reason in people with myeloma the normal growth of new bone tissue is inhibited and new bone growth is very slow or does not occur at all, so drugs like Aredia may only help prevent the further destruction of bone but not help promote new growth to repair damage that is already present.

[Beacon Staff]

Re: Pamidronate (Aredia) - no benefit after 2 yrs?

by Beacon Staff on Thu Oct 31, 2013 11:19 pm

Hi Babs - This recent Beacon article may answer some of your questions (and it also may be useful to others reading this thread):

Experts Publish Treatment Recommendations For Multiple Myeloma-Related Bone Disease

For example:

According to the experts, the evidence is less clear regarding the duration of therapy with Aredia. They therefore recommend that physician discretion determine the duration of treatment with Aredia, and that treatment be resumed at relapse.

The researchers add that the optimal treatment duration is not clear for patients who achieve a very good partial or complete response to their anti-myeloma therapy. The experts recommend, however, that these patients be treated for at least 12 months and up to 24 months and at their physicians’ discretion thereafter.

[NStewart]

Re: Pamidronate (Aredia) - no benefit after 2 yrs?

by NStewart on Fri Nov 01, 2013 12:59 pm

I've been on Zometa infusions for over 4 years. Each time that it has been discontinued - during the time that I had my transplant and when I had joint replacement surgery last year - I developed fractures. So, my oncologist and I feel that it is important that I be continuing on the infusions. Fortunately I haven't developed any of the negative side effects that can develop from the bisphosphonates over the long term.

About 3 years ago I had quite a significant fall tripping on the door sill of my front door and fell down one step onto a concrete landing on both knees. After taking the time to pull myself together and assess any damage before standing up, I realized that I hadn't broken anything. I personally feel that with the force on my bones that occurred with that fall that I would have fractured something if I hadn't been getting the infusions on a regular basis at that time.

Good luck to your husband,
Nancy in Phila

[Dr. Jason Valent]

Re: Pamidronate (Aredia) - no benefit after 2 yrs?

by Dr. Jason Valent on Sun Nov 03, 2013 5:02 pm

The 2 year data refers to patients without active disease.