Denosumab Versus Zoledronic Acid in the Prevention of Skeletal-related Events in Vulnerable Cancer Patients: A Meta-analysis of Randomized, Controlled Trials

Chen, Chaoyang; Li, Ruoming; Yang, Ting; Ma, Lulin; Zhou, Shuang; Li, Min; Zhou, Ying; Chen, Yimin

doi:10.1016/j.clinthera.2020.05.019

Cited by 8 publications

(5 citation statements)

References 48 publications

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“…The benefit of preventing SREs in patients with bone metastases achieved by Dmab was consistently reported across included clinical trials with no interstudy heterogeneity. Previous meta-analyses have also confirmed the advantage of Dmab over ZA in delaying the onset of SREs [21][22][23] . SREs secondary to bone metastases such as pathological fracture, spinal cord compression, radiation or surgery to bone commonly occur clinically 28 , resulting in reduced survival, higher functional independence rates and dramatically lower health-related quality of life 29 .…”

Section: Discussionmentioning

confidence: 73%

“…Growing evidence suggests that Dmab is superior in terms of efficacy 17,18 , safety 5 and even cost-P r e p r i n t effectiveness 19,20 over ZA. Published meta-analyses comparing the efficacy between Dmab and ZA for treatment of bone metastases in patients with solid tumors demonstrated that Dmab was better than ZA in preventing complications and delaying the onset of skeletal-related events (SREs) [21][22][23] .…”

Section: Introductionmentioning

confidence: 99%

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Safety of Denosumab Versus Zoledronic Acid in Patients with Bone-related Diseases A Systematic Review and Meta-analysis

Luo

2021

Arch Med Sci

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IntroductionBoth Dmab and ZA have been widely used in the prevention and treatment of bone-related diseases, while which drug is an optimal treatment in terms of safety and efficacy remains controversial.Material and methodsPubMed, Embase, Web of Science, the Cochrane Central Library, and ClinicalTrials.gov were systematically searched up to 1st January 2021, and were evaluated by Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Randomized controlled trials comparing Dmab versus ZA in patients with bone-related diseases were included.ResultsA total of 13 studies involving 21042 participants were included. The incidence of total adverse events was significantly lower in patients receiving Dmab treatment than in those undergoing ZA treatment(OR= 0.84, 95% CI = 0.75–0.94, P = 0.003). 9 trials comparing Dmab with ZA further showed that Dmab was significantly better than ZA in controlling serious adverse events (OR = 0.91, 95% CI = 0.85–0.99, P = 0.02). Compared to ZA, Dmab was correlated with a lower incidence of skeletal-related events (OR = 0.77, 95% CI = 0.70–0.85, P = 0.00001). However, no significant difference was found in the rate of infection events between Dmab and ZA (OR = 1.06, 95% CI = 0.93–1.20, P =0.39).ConclusionsThis study demonstrated superiority of Dmab over ZA in treating bone-related diseases in terms of safety and efficacy.

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Section: Discussionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Safety of Denosumab Versus Zoledronic Acid in Patients with Bone-related Diseases A Systematic Review and Meta-analysis

Luo

2021

Arch Med Sci

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“…When compared to ZA, denosumab was significantly better at delaying the time to the first skeletal-event and reducing pain. Overall survival and disease progression were similar in both groups [59] , [60] . These results are in accordance with our study regarding the time to the first skeletal-related event.…”

Section: Discussionmentioning

confidence: 74%

Management of bone metastasis with zoledronic acid: A systematic review and Bayesian network meta-analysis

Lorange¹,

Luna²,

Grou-Boileau³

et al. 2023

Journal of Bone Oncology

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“…However, increased incidence of osteonecrosis of the jaw was associated with denosumab as compared to zoledronic acid. A meta-analysis showed similar results for denosumab in the prevention of skeletal-related adverse events as compared to zoledronic acid [ 73 ]. Moreover, an RCT by Smith et al (2012) tested denosumab for the prevention of bone metastasis [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Current Status of Monoclonal Antibodies-Based Therapies in Castration-Resistant Prostate Cancer: A Systematic Review and Meta-Analysis of Clinical Trials

Tarrar¹,

Anwar²,

Ali³

et al. 2022

Cureus

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BackgroundMultiple patients with prostate cancer become resistant to castration therapies, which is termed castrationresistant prostate cancer (CRPC). PurposeThe purpose of this review is to assess the status of efficacy (≥50% decline in prostate-specific antigen (PSA), progression-free survival (PFS), and overall survival (OS)) and safety (grade 3-4 adverse effects) of monoclonal antibodies in CRPC. Data sourceWe searched databases including PubMed, Embase, Cochrane, Web of Science, and ClinicalTrials.gov. ResultsHazard ratios of PFS and OS were 0.77 (95% CI = 0.69-0.87, I 2 = 53%) and 0.98 (95% CI = 0.86-1.11, I 2 = 40%), respectively, in the favor of monoclonal antibodies as compared to placebo. Risk ratio (RR) of >50% decline in PSA was 1.99 (95% CI = 0.97-4.08, I 2 = 53%) in favor of monoclonal antibodies. Pooled incidence of >50% decline in PSA levels was 15% (95% CI = 0.1-0.23, I 2 = 83%), 29% (95% CI = 0.14-0.51, I 2 = 93%), 63% (95% CI = 0.49-0.76, I 2 = 77%), and 88% (95% CI = 0.81-0.93, I 2 = 0%) in single, two, three, and four-drug regimens, respectively. ConclusionMonoclonal antibodies are well tolerated and showed better PFS as compared to placebo. However, OS was only improved with ipilimumab. Denosumab delayed skeletal-related adverse events as compared to zoledronic acid. More multicenter double-blind clinical trials may be needed to confirm these results.

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Denosumab Versus Zoledronic Acid in the Prevention of Skeletal-related Events in Vulnerable Cancer Patients: A Meta-analysis of Randomized, Controlled Trials

Abstract: Bone metastases from solid tumors and multiple myeloma (MM) represent an important source of morbidity. The present meta-analysis was performed with the purpose of comparing the efficacy and tolerability of denosumab versus zoledronic acid

Cited by 8 publications

References 48 publications

Safety of Denosumab Versus Zoledronic Acid in Patients with Bone-related Diseases A Systematic Review and Meta-analysis

Safety of Denosumab Versus Zoledronic Acid in Patients with Bone-related Diseases A Systematic Review and Meta-analysis

Management of bone metastasis with zoledronic acid: A systematic review and Bayesian network meta-analysis

Current Status of Monoclonal Antibodies-Based Therapies in Castration-Resistant Prostate Cancer: A Systematic Review and Meta-Analysis of Clinical Trials

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