Efficacy and safety of denosemab versus zoledronic acid in patients with solid tumors bone metastases and multiple myeloma:a meta-analysis
10.12173/j.issn.1005-0698.202311036
- VernacularTitle:地舒单抗与唑来膦酸在实体肿瘤骨转移和多发性骨髓瘤患者中应用效果和安全性的Meta分析
- Author:
Lulu ZHEN
1
;
Xuemao LIU
;
Jianqi CHEN
;
Hai YANG
Author Information
1. 康复大学青岛中心医院药学部(山东青岛 266042)
- Keywords:
Denosemab;
Zoledronic acid;
Bone metastasis;
Solid tumors;
Multiple myeloma;
Bone-related events;
Meta-analysis;
Randomized controlled trial
- From:
Chinese Journal of Pharmacoepidemiology
2024;33(2):194-202
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically review the efficacy and safety of denosemab and zoledronic acid in patients with solid tumors bone metastases and multiple myeloma.Methods Pubmed,Embase,Cochrane Library,Web of Science,CNKI,WanFang Data and VIP databases were electronically searched for randomized controlled trials(RCTs)related to denosemab and zoledronic acid in the solid tumors bone metastases and multiple myeloma from inception to November 21,2023.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies,and Meta-analysis was performed by using RevMan 5.3 software.Results A total of 5 RCTs,involving 8 957 patients were included.The results of Meta-analysis showed that denosumab was effective in delaying the time to first bone-related event(SRE)(HR=0.85,95％CI 0.80 to 0.92,P＜0.001)and the time to first and subsequent SRE time(HR=0.87,95％CI 0.79 to 0.96,P=0.004)were superior to zoledronic acid.Denosumab had lower incidence of nephrotoxicity(RR=0.70,95％CI 0.58 to 0.85,P＜0.001),acute phase response(RR=0.46,95％CI 0.40 to 0.51,P＜0.001),anemia(RR=0.91,95％CI 0.85 to 0.98,P=0.008)and appetite decreased/anorexia(RR=0.89,95％CI 0.81 to 0.98,P=0.02),but the incidence of hypocalcemia was higher(RR=1.72,95％CI 1.49 to 1.99,P＜0.001).There were no significant differences between denosumab and zoledronic acid in terms of overall survival,time to disease progression,incidence of adverse events and serious adverse events(P＞0.05).Conclusion Current evidence shows that compared with zoledronic acid,denosemab can significantly delay SREs induced by solid tumors bone metastases and multiple myeloma.In terms of safety,the risk of denosemab-induced nephrotoxicity,acute phase reactions,anemia and decreased appetite/anorexia are lower,but the risk of denosemab-induced hypocalcemia is higher.
