Abstract
Bisphosphonates have been a mainstay in the treatment of cancer-related bone disease and have greatly reduced the risk of skeletal complications. More recently, clinical studies suggested additional benefits of denosumab over zoledronic acid in the prevention of skeletal related events. Similar adverse event profiles have been reported for bisphosphonates and denosumab, with infrequent occurrences of osteonecrosis of the jaw with both agents, higher incidence of renal deterioration with zoledronic acid, and higher incidence of hypocalcaemia with denosumab. Based on current evidence, the American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network (NCCN) guidelines do not recommend one drug class over the other in patients with metastatic bone disease. Denosumab, however, may present advantages over bisphosphonates in patients suffering from chronic renal insufficiency. Further research and growing clinical experience will refine the evidence based on which decisions in daily clinical practice can be taken.
| Original language | English |
|---|---|
| Pages (from-to) | 439-447 |
| Number of pages | 9 |
| Journal | Wiener Klinische Wochenschrift |
| Volume | 125 |
| Issue number | 15-16 |
| DOIs | |
| Publication status | Published - Aug 2013 |
| Externally published | Yes |
Keywords
- Antibodies, Monoclonal, Humanized/adverse effects
- Bone Density Conservation Agents/adverse effects
- Bone Neoplasms/complications
- Bone Resorption/drug therapy
- Denosumab
- Diphosphonates/adverse effects
- Evidence-Based Medicine
- Humans
- Imidazoles/adverse effects
- Internationality
- Palliative Care/methods
- Treatment Outcome
- Zoledronic Acid
- Anti-resorptive agents
- Metastatic prostate cancer
- Bisphosphonates
- Metastatic breast cancer
ASJC Scopus subject areas
- General Medicine