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Conversely, while patients are living longer, myeloma bone disease continues to contribute significantly to morbidity and mortality. Routine incorporation of anti\u2010resorptive therapies into patient management is recommended by consensus guidelines; however, patients continue to sustain skeletal\u2010related events, including pathological fractures. In this review, we discuss the diagnosis and pathogenesis of myeloma bone disease and the evidence underpinning guideline recommendations for the use of bisphosphonates in patients with myeloma. 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