狄诺塞麦治疗骨转移效果如何？

Applies to:

1. Prevent skeletal-related events in patients with multiple myeloma and patients with bone metastasis from solid tumors.

2. Treat adult patients with giant cell tumors of bone who are not suitable for surgery and have mature skeletal systems.

3. Treatment of hypercalcemia of malignant tumors that are resistant to bisphosphonates.

4. It is not used to treat patients with multiple myeloma and prevent their bone-related symptoms.

How effective is denosumab in treating bone metastases?

Objective: To systematically evaluate the effectiveness and safety of denosumab and zoledronic acid in the treatment of malignant tumors with bone metastasis.

Methods: The Cochrane library, Pub Med, OVID, Springer Linker, Science Direct, EBSCO and other databases were used to search for literature. The quality of the included literature was evaluated according to the Cochrane risk of bias assessment tool and the literature data were extracted. Meta analysis was performed using Rev Man 5.3 software.

Results: Four clinical randomized controlled trials with a total of 6029 patients were included.

The analysis results show that compared with zoledronic acid, denosumab can significantly delay the occurrence of bone-related events (SREs), reduce the concentration of bone metastasis markers type I collagen cross-linked amino terminal peptide/creatinine (uNTx/Cr) and bone-derived alkaline phosphatase (S-BALP), prevent bone radiotherapy, delay the exacerbation of pain and intervention, and simultaneously treat post-treatment anemia, acute phase reactions and nephrotoxicity. The incidence rate was lower, and the differences were statistically significant (all P<0.01); there were no statistically significant differences in the overall survival (OS) time, disease progression time, prevention of pathological fractures, prevention of bone surgery, prevention of spinal cord compression, and incidence of adverse events (AEs, including nausea, fatigue, back pain, subcollar osteonecrosis, etc.) between the two groups of patients (all P>0.05).

Conclusion: It is superior to zoledronic acid in terms of clinical effectiveness and safety, and provides a new solution for the clinical prevention and treatment of patients with malignant solid tumors and bone metastases.