Patient management issues in metastatic bone disease.
The main goals of bisphosphonate therapy are to prevent and treat skeletal events, minimize disability, and relieve pain without increasing the overall burden that bone metastases (and their treatment) place on patients. The ease and convenience of treatment are important to patients, and there are data suggesting that patients prefer oral therapy over intravenous drugs to help them maintain a normal life. Intravenous therapy with zoledronic acid and pamidronate is currently time-consuming; preparation, renal monitoring, infusion, and follow-up use valuable health care resources. Intravenous ibandronate could help alleviate this burden because of its good renal safety profile. Although efficacious, oral clodronate has compliance problems because of multiple dosing, large tablet size, and gastrointestinal tolerability issues. Recent phase III trials of oral ibandronate have shown efficacy similar to that of intravenous ibandronate, with no compliance or tolerability concerns. Ibandronate appears to have several advantages over current therapies that could improve treatment acceptability and reduce the burden of disease on the health care system. Research continues into the efficacy, safety, and pharmacoeconomics of ibandronate.
Cameron
David
D
Western General Hospital, Edinburgh, UK. david.cameron@ed.ac.uk
D000284:Administration, Oral; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000191:economics / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology; D004164:Diphosphonates / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous
D004164:Diphosphonates