Daoud Neama, Assa Adan Abu, Obed Bayan Abu, Rabea Adan Abu, Abdalla Mazen, Jaber Mohammad Mazoz, Shawahna Ramzi
Department of Medicine, Faculty of Medicine and Allied Health Sciences, An-Najah National University, Nablus, Palestine.
An-Najah National University Hospital, Nablus, Palestine.
BMC Cancer. 2025 Aug 27;25(1):1383. doi: 10.1186/s12885-025-14772-y.
Antiresorptive agents are recommended for patients with bone metastatic disease in order to treat hypercalcemia of malignancy, to reduce skeletal-related events, and to alleviate bone pain. This study was conducted to describe prescribing practices for antiresorptive agents among patients with metastatic bone disease within the Palestinian healthcare system.
We conducted a multicenter, mixed-method study that combined a retrospective analysis of prescription data for antiresorptive agents in patients with metastatic bone disease with a cross-sectional survey of the views and opinions of oncologists and orthopedists practicing within the Palestinian healthcare system regarding the benefits and risks associated with these agents.
In this study, 239 patients with metastatic bone disease were included. The median age of the patients was 61.0 [52.0-69.0] years, the median duration of cancer was 3.0 [1.0-6.0] years, and the median duration of bone metastatic disease was 1.0 [1.0-3.0] years. Of these patients, 139 (58.2%) received antiresorptive agents. Patients prescribed antiresorptive agents were more likely to experience hypoglycemia (p-value = 0.005) compared to those not receiving these agents. The duration of antiresorptive agent use was positively associated with the duration of cancer (Spearman's rho = 0.38, p-value < 0.001) and with the duration of bone metastatic disease (Spearman's rho = 0.45, p-value < 0.001). Among the surveyed oncologists and orthopedists, 40% reported that prescribing antiresorptive agents for patients with bone metastatic disease was routine practice, while 60% indicated that they would recommend antiresorptive agents even if the patient experienced minimal or no pain. Moreover, 70% of the oncologists and orthopedists preferred initiating treatment with zoledronic acid as the first-line antiresorptive agent for patients with bone metastases.
Our study revealed significant variability in the prescribing patterns and dosing schedules of antiresorptive agents, highlighting the need to adopt standardized, evidence-based protocols to enhance patient outcomes and optimize resource allocation in managing bone metastatic disease. Furthermore, future research should focus on evaluating patient-centered outcomes, long-term safety profiles, and the impact of educational and regulatory changes on practice patterns.
对于骨转移疾病患者，推荐使用抗骨吸收药物来治疗恶性肿瘤引起的高钙血症、减少骨相关事件并缓解骨痛。本研究旨在描述巴勒斯坦医疗系统中转移性骨病患者抗骨吸收药物的处方实践情况。
我们开展了一项多中心、混合方法研究，该研究将对转移性骨病患者抗骨吸收药物处方数据的回顾性分析与对巴勒斯坦医疗系统中执业肿瘤学家和骨科医生关于这些药物的益处和风险的观点及意见的横断面调查相结合。
本研究纳入了239例转移性骨病患者。患者的中位年龄为61.0[52.0 - 69.0]岁，癌症的中位病程为3.0[1.0 - 6.0]年，骨转移疾病的中位病程为1.0[1.0 - 3.0]年。在这些患者中，139例（58.2%）接受了抗骨吸收药物治疗。与未接受这些药物的患者相比，接受抗骨吸收药物治疗的患者更有可能发生低血糖（p值 = 0.005）。抗骨吸收药物的使用时长与癌症病程呈正相关（斯皮尔曼等级相关系数 = 0.38，p值 < 0.001），也与骨转移疾病病程呈正相关（斯皮尔曼等级相关系数 = 0.45，p值 < 0.001）。在接受调查的肿瘤学家和骨科医生中，40%报告为骨转移疾病患者开具抗骨吸收药物是常规做法，而60%表示即使患者疼痛轻微或无疼痛，他们也会推荐使用抗骨吸收药物。此外，70%的肿瘤学家和骨科医生倾向于将唑来膦酸作为骨转移患者一线抗骨吸收药物开始治疗。
我们的数据显示抗骨吸收药物的处方模式和给药方案存在显著差异，这凸显了采用标准化、基于证据的方案以改善患者治疗效果并优化骨转移疾病管理中的资源分配的必要性。此外，未来的研究应聚焦于评估以患者为中心的治疗效果、长期安全性概况以及教育和监管变化对实践模式的影响。
