Zhang Zhicai, Pu Feifei, Shao Zengwu
Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Orthopedics, Wuhan No.1 Hospital, Wuhan Integrated TCM & Western Medicine Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
J Bone Oncol. 2017 Oct 3;9:21-24. doi: 10.1016/j.jbo.2017.09.003. eCollection 2017 Nov.
The meta-analysis was used to evaluate the skeletal-related events (SREs) and efficacy of denosumab versus zoledronic acid (ZA) in patients with bone metastases.
The data of this meta-analysis study were searched from PUBMED, EMBASE, Cochrane Library, Web of Science with Conference Proceedings, Elsevier and China National Knowledge Infrastructure (CNKI) databases till August 2017. Two independent reviewers reviewed the reference lists of relevant articles. The fixed-effects model and random-effects model were used to summarize relative estimates and 95% confidence intervals (CIs) according to the heterogeneity of the included studies.
Three randomized controlled trials (RCTs) including 4050 patients were identified in this meta-analysis study. The pooled analysis showed that denosumab could significantly reduce SREs, series SREs [Odds Ratio (OR) = 0.84; 95% CI, 0.74-0.95, I = 0%, P = 0.008] in patients with bone metastases as compared with ZA. Similar results of spinal cord compression SRE and surgery to bone SRE were obtained with (OR = 0.84; 95% CI, 0.70-1.01, I = 0%, P = 0.07) and (OR = 0.92; 95% CI, 0.78-1.08, I = 0%, P = 0.28) separately, radiation to bone SRE (OR = 0.72; 95% CI, 0.46-1.10, I = 11%, P = 0.13) and pathological fracture SRE (OR = 0.78; 95% CI, 0.35-1.73, I = 25%, P = 0.54) showed similar results, there were no significant difference between denosumab and ZA in patients with bone metastases.
Denosumab was more effective than ZA in reducing the incidence of SRE in patients with bone metastases.
采用荟萃分析评估地诺单抗与唑来膦酸（ZA）对骨转移患者骨骼相关事件（SREs）及疗效。
检索截至2017年8月的PUBMED、EMBASE、Cochrane图书馆、科学网会议论文集、爱思唯尔以及中国知网数据库，获取本荟萃分析研究的数据。两名独立评审员查阅相关文章的参考文献列表。根据纳入研究的异质性，采用固定效应模型和随机效应模型汇总相对估计值及95%置信区间（CIs）。
本荟萃分析研究纳入3项随机对照试验（RCTs），共4050例患者。汇总分析显示，与ZA相比，地诺单抗可显著降低骨转移患者的SREs、系列SREs[比值比（OR）=0.84；95%CI，0.74 - 0.95，I = 0%，P = 0.008]。脊髓压迫SRE和骨手术SRE分别得出相似结果（OR = 0.84；95%CI，0.70 - 1.01，I = 0%，P = 0.07）和（OR = 0.92；95%CI，0.78 - 1.08，I = 0%，P = 0.28），骨放疗SRE（OR = 0.72；95%CI，0.46 - 1.10，I = 11%，P = 0.13）和病理性骨折SRE（OR = 0.78；95%CI，0.35 - 1.73，I = 25%，P = 0.54）显示相似结果，地诺单抗与ZA在骨转移患者中无显著差异。
地诺单抗在降低骨转移患者SRE发生率方面比ZA更有效。
