Future directions in managing MBD include (i) targeting specific MM patient populations for aggressive MBD therapy who are at high‐risk for progressive MBD such as genetically defined high‐risk MM patients; (ii) potentially validating the use of bone‐turnover markers in larger studies to optimize the use of MBD therapy in MM patients; and (iii) exploring the use of novel osteoporosis agents such as the anti‐sclerostin monoclonal antibody romosozumab in MBD. This evidence concerns the gene SOST and Marchiafava-Bignami disease.