{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:12:23Z","timestamp":1789193543426,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008363","name":"Kr\u00e6ftens Bek\u00e6mpelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008363","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>The Magnolia study demonstrated that continuation of zoledronic acid (ZOL) beyond 2\u2009years reduces the risk of progressive bone disease (PBD) in patients with multiple myeloma (MM). This follow\u2010up study investigated the effects of ZOL in patients achieving very good partial response (VGPR) compared to patients who did not and whether bone turnover markers could identify patients at an increased risk of PBD following treatment cessation. Two Magnolia trial subgroups were analysed: patients with VGPR or better after 2\u2009years of ZOL, randomized to either continued treatment or observation, and patients randomized to observation in whom serial bone markers (C\u2010terminal cross\u2010linked telopeptide of type I collagen [CTX], procollagen type I N\u2010terminal propeptide [P1NP], bone\u2010specific alkaline phosphatase [BAP], tartrate\u2010resistant acid phosphatase isoform 5b [TRAcP]) were measured for up to 4\u2009years. Continued monthly ZOL beyond 2\u2009years significantly reduced the risk of PBD (hazard ratio 0.40; 95% confidence interval [CI] 0.16\u20130.92) in patients with VGPR or better (subgroup 1). After ZOL discontinuation, bone markers increased gradually. Elevated CTX (\u22650.30\u2009\u03bcg\/L) and TRAcP (\u22654\u2009U\/L) levels were associated with increased 6\u2010month PBD risk (29% and 15% respectively) (subgroup 2). Continuation of ZOL beyond 2\u2009years seems to reduce skeletal progression risk in patients achieving VGPR or better. Elevated CTX or TRAcP levels may help identify patients who could benefit from re\u2010initiating ZOL.<\/jats:p>","DOI":"10.1111\/bjh.70612","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T06:11:12Z","timestamp":1786515072000},"page":"1076-1084","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bone progression in multiple myeloma: Benefit of zoledronic acid for patients achieving at least Very Good Partial Response and prognostic value of bone turnover markers"],"prefix":"10.1111","volume":"209","author":[{"given":"Michael Tveden","family":"Gundesen","sequence":"first","affiliation":[{"name":"Department of Hematology, Odense University Hospital University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette Juul","family":"Vangsted","sequence":"additional","affiliation":[{"name":"Department of Hematology Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Helleberg","sequence":"additional","affiliation":[{"name":"Department of Hematology Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Einar","family":"Hauk\u00e5s","sequence":"additional","affiliation":[{"name":"Department of Blood and Cancer Diseases Stavanger University Hospital  Stavanger Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trine","family":"Silkj\u00e6r","sequence":"additional","affiliation":[{"name":"Department of Hematology Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonna Skov","family":"Madsen","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Immunology, Lillebaelt Hospital University Hospital of Southern Denmark  Odense Denmark"},{"name":"Department of Regional Health Research University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon Thor","family":"Asmussen","sequence":"additional","affiliation":[{"name":"Department of Radiology Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena Manuela","family":"Teodorescu","sequence":"additional","affiliation":[{"name":"Department of Hematology Aalborg University Hospital  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo Amdi","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Hematology Zealand University Hospital  Roskilde Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7488-4863","authenticated-orcid":false,"given":"Tobias Schmidt","family":"Sl\u00f8rdahl","sequence":"additional","affiliation":[{"name":"Department of Hematology St. Olavs Hospital and Norwegian University of Science and Technology (NTNU)  Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aneta Alexandra","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Immunology, Lillebaelt Hospital University Hospital of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorte Aalund","family":"Olsen","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Immunology, Lillebaelt Hospital University Hospital of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7402-314X","authenticated-orcid":false,"given":"Kent","family":"S\u00f8e","sequence":"additional","affiliation":[{"name":"Clinical Cell Biology, Research Unit of Pathology, Department of Clinical Research University of Southern Denmark  Odense Denmark"},{"name":"Department of Pathology Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hareth","family":"Nahi","sequence":"additional","affiliation":[{"name":"Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Waage","sequence":"additional","affiliation":[{"name":"Department of Hematology St. Olavs Hospital and Norwegian University of Science and Technology (NTNU)  Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"Abildgaard","sequence":"additional","affiliation":[{"name":"Department of Hematology, Odense University Hospital University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrik","family":"Schjesvold","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oslo Myeloma Center Oslo University Hospital  Oslo Norway"},{"name":"K.G. 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