Safety and efficacy of the new bisphosphonate ibandronate in the management of bone metastasis following rapid infusion.
BACKGROUND
We evaluated the safety and efficacy of the new BP ibandronate, given as a rapid infusion.


METHODS
We administered 4 mg of ibandronate as an intravenous infusion over 30 minutes. Thirty patients (16 breast cancers, 4 prostate cancers, 10 multiple myelomas) with bone metastases received 4 mg of ibandronate injected intravenously over 30 minutes in normal saline 0.9%, 250cc every 3 or 4 weeks. The patients were followed-up over 2 hours after infusion. A total of 198 infusions were administered over a period of 24 months and the patients were followed-up for long-term ibandronate-related side-effects, as well as for any potential clinical benefit.


RESULTS
Following the first administration of ibantronate, serum levels of calcium, phosphate and alkaline phosphatase were significantly decreased and the difference was statistically significant (p < 0.001) for all three parameters examined. The reduced time of infusion (30 minutes vs 2 hours) did not correlate with any side-effects during or post-administration. Serum levels of creatinine and urea nitrogen did not increase significantly, while changes in temperature and blood pressure were not detected in the patients examined. With regard to efficacy, all the patients, after repeated administrations, reduced the doses of analgesics needed; 26 out of 30 patients had stable disease in the bones while 1 out of 30 patients had significant improvement of bone lesions in consecutive bone scans.


CONCLUSIONS
Infusional administration of ibandronate is efficient in the management of hypercalcaemia of malignancy and it results in a reduced need for analgesics. The rapid infusion over 30 minutes is safe and could be given in the setting of a day care unit.
Syrigos
Konstantinos N
KN
Oncology/Haematology Unit, 3rd Department of Medicine, Sotiria General Hospital, Athens Medical School, Athens, Greece. knsyrigos@usa.net
Michalaki
Vicky
V
Mitromaras
Athanasios
A
Pliarchopoulou
Fani
F
Katirtzoglou
Nikolaos
N
Antonaki
Eleftheria
E
Roussou
Paraskevi
P
D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000556:secondary*; D001862:Bone Resorption / Q000517:prevention & control; D002118:Calcium / Q000097:blood; D004164:Diphosphonates / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000188:drug therapy / Q000209:etiology; D000077557:Ibandronic Acid; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000097:blood
D000970:Antineoplastic Agents; D004164:Diphosphonates; D010710:Phosphates; D000469:Alkaline Phosphatase; D002118:Calcium; D000077557:Ibandronic Acid