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Bisphosphonates for Patients Diagnosed With Multiple Myeloma. Clinical Question: Among patients with multiple myeloma, is bisphosphonate therapy associated with lower rates of mortality, vertebral fractures, nonvertebral fractures, and skeletal-related events compared with placebo or no treatment? Bottom Line: Among patients with myeloma, bisphosphonates were associated with lower rates of pathological fractures and skeletal-related events compared with placebo or no treatment. Direct meta-analysis showed no association between bisphosphonates and mortality. In network meta-analysis, zoledronate was associated with lower risk of mortality compared with placebo or no treatment.