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Review: bisphosphonates reduce fractures, radiotherapy, and hypercalcaemia and increase time to a first skeletal related event

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 Q In cancer patients with bone metastases, do bisphosphonates reduce skeletal morbidity?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★☆☆ Oncology ★★★★★★☆


Embedded ImageData sources:

Medline (1966–2001), CancerLit (1975–2001), EMBASE/Excerpta Medica (1980–2001), Science Citation Index Expanded (1981–2001), the Cochrane library, the database of abstracts of reviews of effectiveness (DARE), bibliographies of relevant papers, key journals, meeting abstracts, and experts and pharmaceutical companies.

Embedded ImageStudy selection and assessment:

randomised controlled trials that included patients with malignant disease and bone metastases; measured ⩾1 skeletal morbidity outcome; and compared an oral or intravenous bisphosphonate with another bisphosphonate, placebo, or standard care. Studies of patients with multiple myeloma were included but studies of patients with other haematological malignancies were excluded. Studies were assessed for allocation concealment and blinding.

Embedded ImageOutcomes:

reduction in skeletal …

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  • For correspondence: Dr J R Ross, Royal Marsden Hospital, London, UK.

  • Source of funding: NHS Health and Technology Assessment Programme.