Bisphosphonates in multiple myeloma: a network meta-analysis

Mhaskar, Rahul; Redzepovic, Jasmina; Wheatley, Keith; Clark, Otávio; Miladinović, Branko; Glasmacher, Axel; Kumar, Amit; Djulbegoviĉ, Benjamin

doi:10.1002/14651858.cd003188.pub3

Cited by 86 publications

(82 citation statements)

References 131 publications

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“…A recent metaanalysis was not able to confirm superiority of ZA over pamidronate, but remarkably revealed a survival advantage of ZA versus placebo. 24 This analysis also showed that in order to prevent one SRE, we need to treat 6-15 MM patients with BP.…”

Section: Gradementioning

confidence: 95%

European Myeloma Network Guidelines for the Management of Multiple Myeloma-related Complications

et al. 2015

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Section: Gradementioning

confidence: 95%

European Myeloma Network Guidelines for the Management of Multiple Myeloma-related Complications

et al. 2015

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“…preparations of zoledronic acid, pamidronate, and ibandronate and oral formulations of ibandronate and clodronate. As a class, bisphosphonates have been shown, in Cochrane meta-analyses, to be effective for the treatment and prevention of SREs and/or bone pain in advanced breast cancer (12), multiple myeloma (13), and prostate cancer (14). The Cochrane Collaboration has also shown the receptor activator of nuclear factor kB (RANK) ligand inhibitor, denosumab, to be an effective bone-targeted therapy (12).…”

Section: Introductionmentioning

confidence: 99%

“…MTCs are increasingly being used to provide insight into the comparative merits of different therapies in the absence of head-to-head studies and are recognized and recommended by NICE for use in their technology appraisals where direct comparison is lacking (24). The MTC approach has also been adopted by the Cochrane Collaboration in a number of recent systematic reviews (25,26), although not in the comparisons of bisphosphonates (12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Comparative Efficacy of Bisphosphonates in Metastatic Breast and Prostate Cancer and Multiple Myeloma: A Mixed-Treatment Meta-analysis

Palmieri

Fullarton

Brown

2013

Clinical Cancer Research

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Purpose: A mixed-treatment comparison (MTC) was undertaken to compare the efficacy of zoledronic acid, clodronate, pamidronate, and ibandronate (i.v. and oral) in patients with skeletal-related events (SRE) secondary to metastatic breast and prostate cancer and multiple myeloma.Experimental Design: Studies of bisphosphonates in the three malignancies were identified and SRE data were extracted. Outcomes from the MTC were expressed as the annual SRE rate and as the mean likelihood (probability) ratio for the rate of SREs during treatment with zoledronic acid compared with the other bisphosphonates.Results: A total of 17 studies were identified (7 breast, 3 prostate, and 7 multiple myeloma). Data were available for all bisphosphonates in breast cancer; no data were available for ibandronate (oral or i.v.) in prostate cancer or for oral ibandronate in multiple myeloma. The SRE rates in breast cancer were 1.60 for zoledronic acid, 1.67 for oral ibandronate (excess SRE rate, 4%), 1.70 for i.v. ibandronate (6%), 2.07 for pamidronate (29%), and 2.29 for clodronate (42%). In prostate cancer, the SRE rates were 0.83 for zoledronic acid, 1.11 for clodronate (35%), and 1.41 for pamidronate (71%). In multiple myeloma, the SRE rates were 1.43 for zoledronic acid, 1.64 for pamidronate (15%), 1.90 for clodronate (33%), and 2.49 for i.v. ibandronate (75%).Conclusions: Zoledronic acid seems to be the most efficacious bisphosphonate for reducing the risk of SREs in patients with cancer of the breast or prostate and those with multiple myeloma.

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“…Whether zoledronate is superior to pamidronate and other bisphosphonates remains to be determined. 171 These NCCN Guidelines recommend bisphosphonates for all patients receiving myeloma therapy for symptomatic disease regardless of documented bone disease (category 1). In patients with smoldering or stage I MM, according to the NCCN panel, bisphosphonates may be considered but preferably in a clinical trial.…”

mentioning

confidence: 99%