Limited benefits from bisphosphonates for advanced prostate cancer

Low-quality evidence showed no clinically relevant difference between bisphosphonates and control regimens in the proportion of participants with pain response, in men with bone metastases from prostate cancer. There was moderate-quality evidence that bisphosphonates decreased the total number of skeletal-related events and the proportion of participants with disease progression in comparison with control regimens. The advantageous effect of bisphosphonates on the composite outcome of skeletal-related events was more distinct in pathological fractures, spinal cord compressions and bone surgery. However, there was an increased risk of renal impairment and nausea in men receiving bisphosphonates. Very low to moderate-quality evidence supported no clear difference in mortality, quality of life (QoL) and osteonecrosis of the jaw using bisphosphonates relative to control regimens.