Document Detail

Denosumab and bone metastases. No better than a bisphosphonate.
MedLine Citation:
PMID:  23016249     Owner:  NLM     Status:  MEDLINE    
The standard treatment used to prevent clinical repercussions of bone metastases from solid tumours consists of an intravenous bisphosphonate such as pamidronic acid. Denosumab,a monoclonal antibody injected subcutaneously, has been licensed in the European Union for use in this setting. Three double-blind randomised trials including a total of about 6000 patients showed no tangible difference between denosumab and zoledronic acid in terms of mortality, disease progression, quality of life, or pain. The authors resorted to a composite endpoint in order to demonstrate a statistically significant difference in favour of denosumab. Overall, toxicity was similar with denosumab and zoledronic acid in the 3 trials. Adverse effects that were more frequent with denosumab than with zoledronic acid included jaw osteonecrosis (1.8% versus 1.3%) and hypocalcaemia (9.3% versus 4.7%). However, renal failure was less frequent (2.6% versus 3.7%). Denosumab is administered subcutaneously and zoledronic acid by intravenous infusion. It is not known whether local and systemic reactions to administration are different. In practice, there is no tangible reason to choose denosumab rather than a bisphosphonate.
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Prescrire international     Volume:  21     ISSN:  1167-7422     ISO Abbreviation:  Prescrire Int     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-28     Completed Date:  2012-10-23     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  9439295     Medline TA:  Prescrire Int     Country:  France    
Other Details:
Languages:  eng     Pagination:  204-6     Citation Subset:  T    
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MeSH Terms
Antibodies, Monoclonal, Humanized / administration & dosage,  adverse effects,  therapeutic use*
Antineoplastic Agents / administration & dosage,  adverse effects,  therapeutic use*
Bone Density Conservation Agents / administration & dosage,  adverse effects,  therapeutic use*
Bone Neoplasms / complications,  drug therapy*,  mortality,  secondary
Diphosphonates / administration & dosage,  adverse effects,  therapeutic use*
Evidence-Based Medicine
Imidazoles / administration & dosage,  adverse effects,  therapeutic use*
Infusions, Intravenous
Injections, Subcutaneous
Risk Assessment
Risk Factors
Treatment Outcome
Reg. No./Substance:
0/Antibodies, Monoclonal, Humanized; 0/Antineoplastic Agents; 0/Bone Density Conservation Agents; 0/Diphosphonates; 0/Imidazoles; 118072-93-8/zoledronic acid; 4EQZ6YO2HI/denosumab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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