Prevention

Why?

• It reduces vertebral fractures and pain without clearly affecting hypercalcaemia ^a
• Fewer patients require radiation to bone ^a

Multiple myeloma: regular bisphosponates reduce vertebral fractures and pain 

Patient	Treatment	Comparison	Outcome	CER	OR (95% CI)	NNT (95% CI)
multiple myeloma a	regular bisphosponates	placebo	vertebral fractures at months	35%	0.59 (0.45 to 0.78)	9 (6 to 19)
			reduction in pain atmonths	51%	0.59 (0.46 to 0.76)	8 (5 to 15)

Multiple myeloma: regular pamidronate reduces skeletal complications

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
multiple myeloma and ≥ 1 osteolytic lesion a	pamidronate 90mg every 4 weeks	placebo	radiation treatment to bone at 9 months	22%	35% (0% to 58%)	13 (6 to 3000)