title: Ibandronate to treat skeletal-related events and bone pain in metastatic bone disease or multiple myeloma: a meta-analysis of randomised clinical trials.
abstract: OBJECTIVE
  Randomised controlled trials (RCTs) have given contradictory results about the efficacy and safety of ibandronate in treating metastatic bone disease (MBD) or multiple myeloma. This review meta-analysed the literature to gain a more comprehensive picture.
  
  
  METHODS
  Systematic review and meta-analysis of ibandronate compared with placebo or zoledronate.
  
  
  METHODS
  PubMed, EMBASE and the Cochrane Library databases were systematically searched to identify RCTs published up to March 2015 evaluating ibandronate to treat MBD or multiple myeloma.
  
  
  METHODS
  10 RCTs involving 3474 patients were included. Six RCTs were placebo-controlled and four compared ibandronate with zoledronate. The studies included in this review were mainly from European countries.
  
  
  RESULTS
  Intravenous ibandronate (6 mg) or oral drug (50 mg) decreased the risk of skeletal-related events compared to placebo (risk ratio (RR) 0.80, 95% CI 0.71 to 0.90, p=0.002). It also reduced the bone pain score below baseline significantly more than did placebo at 96 weeks (weighted mean difference -0.41, 95% CI -0.56 to -0.27, p<0.001). The incidence of diarrhoea, nausea and adverse renal events was similar between the ibandronate and placebo groups, but ibandronate was associated with greater risk of abdominal pain. Ibandronate was associated with similar risk of skeletal-related events as another bisphosphonate drug, zoledronate (RR 1.02, 95% CI 0.82 to 1.26, p=0.87). The incidence of nausea, jaw osteonecrosis and fatigue was similar for the two drugs, but the incidence of adverse renal events was significantly lower in the ibandronate group.
  
  
  CONCLUSIONS
  Ibandronate significantly reduces the incidence of skeletal-related events and bone pain in patients with MBD or multiple myeloma relative to placebo. It is associated with a similar incidence of skeletal-related events as zoledronate.
authors.affiliation: Department of Anesthesiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People's Republic of China.
authors.forename: Chun-Jing
authors.initials: CJ
authors.lastname: Geng
authors.affiliation: Postgraduate School of Guangxi Medical University, Nanning, People's Republic of China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Liang
authors.affiliation: Hepatobiliary Surgery Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People's Republic of China.
authors.forename: Jian-Hong
authors.initials: JH
authors.lastname: Zhong
authors.affiliation: Department of Anesthesiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People's Republic of China.
authors.forename: Min
authors.initials: M
authors.lastname: Zhu
authors.affiliation: Department of Anesthesiology, Affiliated Hospital of Chifeng University, Inner Mongolia Autonomous Region, Nanning, People's Republic of China.
authors.forename: Fan-Ying
authors.initials: FY
authors.lastname: Meng
authors.affiliation: Department of Anesthesiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People's Republic of China.
authors.forename: Ning
authors.initials: N
authors.lastname: Wu
authors.affiliation: Department of Anesthesiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People's Republic of China.
authors.forename: Rui
authors.initials: R
authors.lastname: Liang
authors.affiliation: Out-patient Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People's Republic of China.
authors.forename: Bin-Yi
authors.initials: BY
authors.lastname: Yuan
mesh_terms: D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000150:complications* / Q000556:secondary; D001862:Bone Resorption / Q000188:drug therapy* / Q000209:etiology; D004164:Diphosphonates / Q000627:therapeutic use*; D005060:Europe; D006801:Humans; D000077557:Ibandronic Acid; D009101:Multiple Myeloma / Q000150:complications* / Q000556:secondary; D059352:Musculoskeletal Pain / Q000188:drug therapy* / Q000209:etiology; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data*; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D000077557:Ibandronic Acid
keywords: ONCOLOGY