Geng, C.J., Liang, Q., Zhong, J.H., Zhu, M., Meng, F.Y., Wu, N., . . . Yuan, B.Y. (2015). Ibandronate to treat skeletal-related events and bone pain in metastatic bone disease or multiple myeloma: A meta-analysis of randomised clinical trials. BMJ Open, 5(6), e007258-2014-007258.
STUDY PURPOSE: To evaluate the effects of ibandronate relative to placebo or zolendronate for treatment of skeletal-related events and bone pain in patients with cancer
TYPE OF STUDY: Meta-analysis and systematic review
PHASE OF CARE: Late effects and survivorship
APPLICATIONS: Palliative care
IV or oral ibandronate was significantly better than placebo for pain reduction (WMD = -0.41, p < 0.00001). No significant differences in pain outcomes were seen between ibandronate and zoledronate. Incidence of renal toxicity was lower with ibandronate compared to zoledronate (RR = 0.71, p = 0.006). Incidence of skeletal-related events was lower with ibandronate compared to placebo (p = 0.002). There was no significant difference in skeletal-related events between ibandronate and zolendronate and no difference in other adverse events.
IV ibandronate every three to four weeks or daily oral medication was effective in reducing skeletal events and pain in patients with bone metastases, and was associated with lower incidence of renal toxicity than zoledronate.
Ibandronate is effective in reducing pain from bone metastases and multiple myeloma, and in preventing skeletal events in these patients, with efficacy similar to that of zoledronate. This analysis also showed that ibandronate was associated with lower prevalence of renal toxicity compared to zoledronate, so it may be a preferred choice for some patients with relevant comorbid conditions. Further research is needed to fully compare efficacy of oral versus IV administration.