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Limited benefits from bisphosphonates for advanced prostate cancer
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Limited benefits from bisphosphonates for advanced prostate cancer
Compared with control regimens, how effective are bisphosphonates in men with bone metastases from 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.
It was not possible to judge the quality of evidence for QoL because the studies did not report this outcome in a way allowing a meta-analysis.
Bone fractures and compression of the spinal cord are feared complications in addition to death due to prostate cancer. Bisphosphonates interact with the formation of new bone and might be useful to prevent men from experiencing bone pain, fractures or other skeletal complications.
Cochrane Systematic Review Macherey S et al. Bisphosphonates for advanced prostate cancer. Cochrane Reviews, 2017, Issue 12. Art. No.: CD006250.DOI: 10.1002/14651858. CD006250.pub2. This review contains 18 studies involving 4843 participants.