Widyadharma I Putu Eka, Tertia Clarissa, Vania Aurelia, Tiffani Pamela, Wiratnaya I Gede Eka
Department of Neurology, Faculty of Medicine, Universitas Udayana, Prof. Dr. IGNG Ngoerah General Hospital, Bali, Indonesia.
Department of Neurology, Eka Hospital, Pekanbaru, Indonesia.
Postep Psychiatr Neurol. 2024 Sep;33(3):172-177. doi: 10.5114/ppn.2024.144603. Epub 2024 Oct 30.
Skeletal-related events (SREs) are common complications of bone metastases that include the need for radiation or surgery to bone, pathological and radiological fractures, and hypercalcemia. Available data indicate that significant bone pain is associated with SREs, leading to an increased risk of death, higher medication costs, and reduced quality of life for patients. Bisphosphonate agents and denosumab are therapeutic options for preventing SREs in advanced cancer patients with bone metastases. This study aims to compare the effect of denosumab and zoledronic acid in SREs, with a particular focus on pain-related SREs.
Three scientific databases - PubMed, the Cochrane Library, and Google Scholar - were selected and searched for articles published in English up to March 2023. Also, a manual search of related articles was conducted. From the systematic search, four randomized clinical trial studies were identified and further assessed using the Cochrane Collaboration Risk of Bias Tool.
Denosumab was found to have outcomes that are not inferior to Zoledronic acid in delaying the first incidence of SREs, which include pathologic fracture, radiotherapy to bone, surgery to bone, or spinal cord compression. This review concludes that both therapies effectively reduce pain and prevent SREs in cancer patients at risk.
骨相关事件（SREs）是骨转移的常见并发症，包括对骨骼进行放疗或手术的需求、病理性和放射性骨折以及高钙血症。现有数据表明，严重的骨痛与SREs相关，会导致死亡风险增加、药物成本升高以及患者生活质量下降。双膦酸盐类药物和地诺单抗是预防晚期骨转移癌患者发生SREs的治疗选择。本研究旨在比较地诺单抗和唑来膦酸对SREs的影响，特别关注与疼痛相关的SREs。
选择了三个科学数据库——PubMed、Cochrane图书馆和谷歌学术搜索——并检索截至2023年3月以英文发表的文章。此外，还对手相关文章进行了手动检索。通过系统检索，确定了四项随机临床试验研究，并使用Cochrane协作偏倚风险工具进行了进一步评估。
发现地诺单抗在延迟SREs的首次发生方面的结果不劣于唑来膦酸，SREs包括病理性骨折、骨骼放疗、骨骼手术或脊髓压迫。本综述得出结论，两种疗法都能有效减轻癌症高危患者的疼痛并预防SREs。
