Calcium Metabolism and Osteoporosis Program, Division of Endocrinology and Metabolism, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
BMJ Open. 2021 Oct 11;11(10):e051141. doi: 10.1136/bmjopen-2021-051141.
Hypercalcaemia of malignancy (HCM) is the second most common cause of hypercalcaemia and is associated with significant morbidity and mortality. Several treatment options are available including pharmacological therapy with bisphosphonates, denosumab, glucocorticoids and calcimimetics, as well as conventional therapy with hydration and possibly calcitonin. While guidelines have previously considered treatment effects, no guideline has yet considered a range of contextual factors impacting recommendations for the management. The aim of this study was to summarise the available evidence on important decisional factors for the development of guidelines for the treatment of HCM. These include patient's values and preferences, cost, acceptability, feasibility and equity.
This protocol is registered in PROSPERO (registration number: CRD42021264371). This is a systematic review of observational studies, case series, trials, reviews and qualitative studies involving treatment of adult patients with HCM. We will develop and execute two independent search strategies using five databases: PubMed, Medline (OVID), Embase.com, CINAHL (EBSCO) and Cochrane, and review their combined output. Two reviewers will screen titles and abstracts and full texts and will implement data abstraction from relevant studies independently and in duplicate. The outcomes of interest are the decisional factors that influence drug selection, with possible subgroup summaries by drug class or aetiology of HCM. We will present the data collected in a narrative and thematic approach.
Ethical approval is not applicable for our study, since we will only collect data from available literature. This systematic review will be submitted to a peer-reviewed journal when completed.
恶性肿瘤相关性高钙血症（HCM）是引起高钙血症的第二大常见原因，与显著的发病率和死亡率相关。有多种治疗选择，包括双膦酸盐、地舒单抗、糖皮质激素和钙敏感受体激动剂的药物治疗，以及水化和可能使用降钙素的常规治疗。尽管之前的指南已经考虑了治疗效果，但尚无指南考虑影响 HCM 治疗管理建议的一系列背景因素。本研究旨在总结治疗 HCM 指南制定中重要决策因素的现有证据。这些因素包括患者的价值观和偏好、成本、可接受性、可行性和公平性。
本方案已在 PROSPERO（注册号：CRD42021264371）中注册。这是一项对涉及成年 HCM 患者治疗的观察性研究、病例系列、试验、综述和定性研究的系统评价。我们将使用五个数据库（PubMed、Medline（OVID）、Embase.com、CINAHL（EBSCO）和 Cochrane）制定并执行两个独立的检索策略，并对其综合输出进行审查。两名审查员将独立且重复筛选标题和摘要以及全文，并从相关研究中实施数据提取。感兴趣的结果是影响药物选择的决策因素，可能按药物类别或 HCM 的病因学进行亚组总结。我们将以叙述性和主题性方法呈现收集到的数据。
我们的研究不需要伦理批准，因为我们只会从现有文献中收集数据。本系统评价完成后将提交给同行评议的期刊。
