such as denosumab (anti-RANKL),
sotatercept (activin A antagonist), romosozumab (anti-sclerostin) or BHQ-880 (anti-dickkopf 1). Currently, bisphosphonates are the cornerstone in the treatment of myeloma
related bone disease. Zoledronic acid and pamidronate are used in this setting with very
good results in reducing skeletal-related events, but they cannot be used in patients with
severe renal impairment. Furthermore, they have some rare but serious adverse events
including osteonecrosis of the jaw and acute renal insufficiency. This review paper focuses on the latest advances in the pathophysiology of myeloma bone disease and in the
current and future treatment options for its management.