Should patients with POEMS syndrome [polyneuropathy, organomegaly, endocrinopathy/edema, M-protein, and skin abnormalities] be treated with bisphosphonates?
Patients with POEMS syndrome demonstrate osteosclerotic rather than osteolytic disease. They have not been carefully studied for evidence of increased osteoclast activity. Until that is demonstrated, I do not think that treating them with bisphosphonates is appropriate because bisphosphonates target formation and activity of osteoclasts.
