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The anti\u2010receptor activator of nuclear factor\u2010\u03ba\u0392 ligand (RANKL)\u2010targeted agent denosumab has shown its non\u2010inferiority compared to bisphosphonates in preventing skeletal\u2010related events among newly diagnosed patients with myeloma bone disease. Denosumab may confer a survival benefit in patients eligible for autologous transplantation. Denosumab may present a safer profile for patients with renal impairment. Discontinuation of bone\u2010directed therapies can be considered for patients with deep responses and after an adequate time period on treatment; however, a rebound effect may become evident especially in the case of denosumab. Three\u2010monthly infusions of zoledronic acid or at\u2010home denosumab administration should be considered during the coronavirus disease 2019 (COVID\u201019) pandemic. Measures to prevent hypocalcaemia, renal toxicity and osteonecrosis of the jaw are important for all bone\u2010modifying agents.<\/jats:p>","DOI":"10.1111\/bjh.17256","type":"journal-article","created":{"date-parts":[[2020,11,29]],"date-time":"2020-11-29T09:14:35Z","timestamp":1606641275000},"page":"1034-1043","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Controversies in the use of new bone\u2010modifying therapies in multiple myeloma"],"prefix":"10.1111","volume":"193","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5133-1422","authenticated-orcid":false,"given":"Evangelos","family":"Terpos","sequence":"first","affiliation":[{"name":"Department of Clinical Therapeutics School of Medicine National and Kapodistrian University of Athens  Athens 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