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Bone antiresorptives, mostly bisphosphonates, are used in the treatment of metastatic bone disease from solid malignancies to reduce bone destruction, pain and skeleton-related events (SREs). Von Moos and colleagues [1] have reported pooled results from three randomized, identically designed, double-blind trials comparing subcutaneous denosumab (120 mg every 4 weeks) and intravenous zoledronic acid (4 mg/month) in patients with bone metastases from breast cancer ([i]n[/i] = 2406), castration-resistant prostate cancer ([i]n[/i] = 1901) or other solid tumors ([i]n[/i] = 1597). The endpoints were pain severity, pain interference, health-related quality of life and analgesic use. Onset of moderate/severe pain was delayed by 1.8 months by denosumab treatment (hazard ratio (HR) 0.83; 95% CI 0.76–0.92; [i]p[/i]  <  0.001) and clinically meaningful increases in overall pain interference by 2.6 months (HR 0.83; 95% CI 0.75–0.92; [i]p[/i] <  0.001) as compared with zoledronic acid. In addition, the need for strong opioids and reduction of health-related quality of life were less common with denosumab.


  • Faustino R. Pérez-López
    Professor of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine & Lozano Blesa University Hospital, Zaragoza, Spain


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