International Society of Geriatric Oncology (SIOG) clinical practice recommendations for the use of bisphosphonates in elderly patients.
A society of geriatric oncology (SIOG) task force reviewed information from the literature (in PubMed) on bisphosphonates in elderly patients with bone metastases until December 2005. Additional pertinent data were obtained from the manufacturers. Bisphosphonates are recommended in the elderly with bone metastases to prevent skeletal-related events. Intravenous formulations are preferred for the treatment of hypercalcaemia. It has been recognised that zoledronic acid, ibandronate and pamidronate can effectively contribute in relieving metastatic bone pain. Creatinine clearance should be monitored in every patient, and a less renally toxic agent should be used where evidence of similar efficacy is available. The assessment and optimisation of hydration status is recommended. Due to the risk from osteonecrosis of the jaw, routine oral examination and treatment of dental problems by a dental team is recommended before bisphosphonates. Physicians should choose the most appropriate bisphosphonate. Safety precautions are particularly important in elderly patients. Further research is needed in this population.
Body
Jean-Jacques
JJ
Université Libre de Bruxelles, Institut Jules Bordet and CHU Brugmann, Brussels, Belgium. jj.body@bordet.be
Coleman
Rob
R
Clezardin
Philippe
P
Ripamonti
Carla
C
Rizzoli
Rene
R
Aapro
Matti
M
D000284:Administration, Oral; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015415:Biomarkers; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary*; D001862:Bone Resorption / Q000139:chemically induced* / Q000517:prevention & control; D002985:Clinical Protocols; D004164:Diphosphonates / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D009369:Neoplasms / Q000188:drug therapy*; D010020:Osteonecrosis / Q000139:chemically induced / Q000628:therapy
D000970:Antineoplastic Agents; D015415:Biomarkers; D050071:Bone Density Conservation Agents; D004164:Diphosphonates