COMPARISON OF ORAL VERSUS INTRAVENOUS CLODRONATE IN PATIENTS WITH SKELETAL METASTASIS WITH RESPECT TO BONE MINERAL DENSITY AND PAIN SCORE

Authors

  • Abdus Samad Syed Consultant Oncologist, Combined Military Hospital, Lahore, Pakistan
  • Fauzia Abdus Samad Fauji Foundation Hospital, Rawalpindi, Pakistan

DOI:

https://doi.org/10.69656/pjp.v13i4.283

Keywords:

skeletal metastasis, DEXA scan, Clodronate

Abstract

Background: Clodronate is a bisphosphonate available both in oral as well as intravenous formulations. It is one of the effective drugs painful skeletal metastasis. The present study aimed at comparison of oral vs intravenous formulation with regard to improvement in bone mineral density and pain score among patients having skeletal metastasis. Methods: Two hundred patients having any cancer with skeletal metastasis were included in the study. They were given either oral Clodronate or intravenous Clodronate for six months and a comparison was made between them with regard to improvement in bone mineral density and pain score. Results: Out of 200 patients 135 were males and 65 females with a mean age of 54 years. Mean T score of patients on oral treatment before start of treatment was -2.42 that improved to -2.15 (p<0.005) after 6 months of therapy. Mean T-score of patients on intravenous therapy at baseline was -2.37 also improved to -2.11 (p<0.005) after 6 months of therapy. The two arms of treatment did not show statistically significant difference in pre- and post-treatment T scores. The mean pain score of the patients receiving oral Clodronate at the start of treatment was 7.33 that improved to 3.13 (p<0.005) while among patients on intravenous Clodronate it improved from 7.37 to 3.11 (p<0.005). The comparative improvement in pain scores in the two arms was not significantly different (p=0.909). Conclusion: Clodronate improves both T score on DEXA-scan and pain score among patients with skeletal metastasis irrespective of the route of administration.

Pak J Physiol 2017;13(4):23–5

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References

1. Coleman RE. Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res 2006;12(20 pt 2):6243–9s.
2. Brown JE, Cook RJ, Major P, Lipton A, Saad F, Smith M, et al. Bone turnover markers as predictors of skeletal complications in prostate cancer, lung cancer, and other solid tumors. J Natl Cancer Inst 2005;97(1):59–69.
3. Coleman RE, Bisphosphonates: clinical experience. Oncologist 2004;9(Suppl 4):14–27.
4. Paterson AH, Powles TJ, Kanis JA, McCloskey E, Hanson J, Ashley S. Double blind controlled trial of oral clodronate in patients with bone metastases from breast cancer. J Clin Oncol 1993;11(1):59–65.
5. Body JJ, Diel IJ, Lichinitzer M, Lazarev A, Pecherstorfer M, Bell R, et al. Oral ibandronate reduces the risk of skeletal complications in breast cancer patients with metastatic bone disease: results from two randomized, placebo-controlled phase III studies. Br J Cancer 2004;90:1133–7.
6. Rosen LS, Gordon D, Kaminski M, Howell A, Belch A, Mackey J, et al. Long-term efficacy and safety of zoledronic acid compared with pamidronate disodium in treatment of skeletal complications in patients with advanced multiple myeloma or breast cancer: a randomized, double-blind, multicenter, comparative trial. Cancer 2003;98:1735–44.
7. Berenson JR, Lichtenstein A, Porter L, Dimopoulos MA, Bordoni R, George S, et al. Efficacy of pamidronate in reducing skeletal events in patients with advanced multiple myeloma. N Engl J Med 1996;334:488–93.
8. Roelofs AJ, Thompson K, Gordon S, Rogers MJ. Molecular mechanisms of action of bisphosphonates: current status. Clin Cancer Res 2006;12(20 Pt 2):6222–30S.
9. Powles T, Patterson A, McCloskey E, Schein P, Scheffler B, Tidy A, et al. Reduction in bone relapse and improved survival with oral clodronate for adjuvant treatment of operable breast cancer. Breast Cancer Res 2006; 8(2): R13.
10. Hillner BE, Ingle JN, Chlebowski RT, Gralow J, Yee GC, Janjan NA, et al. American Society of Clinical Oncology 2003 update on the role of bisphosphonates and bone health issues in breast cancer. J Clin Oncol 2003;21:4042–57.
11. Berenson JR, Hillner BE, Kyle RA, Anderson K, Lipton A, Yee GC, et al; American Society of Clinical Oncology Bisphosphonates Expert Panel. American Society of Clinical Oncology Clinical Practice Guidelines: the role of bisphosphonates in multiple myeloma. J Clin Oncol 2002;20:3719–36.
12. Chlebowski RT, Col N. Bisphosphonates and breast cancer incidence and recurrence. Breast Dis 2011;33(2):93–101.
13. Webster MR, Zhao M, Rudek MA, Hann CL, Freel Meyers CL. Bisphosphonamidate clodronate prodrug exhibits potent anticancer activity in non-small-cell lung cancer cells. J Med Chem 2011;54:6647–56.

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Published

31-12-2017

How to Cite

1.
Syed AS, Samad FA. COMPARISON OF ORAL VERSUS INTRAVENOUS CLODRONATE IN PATIENTS WITH SKELETAL METASTASIS WITH RESPECT TO BONE MINERAL DENSITY AND PAIN SCORE. Pak J Phsyiol [Internet]. 2017 Dec. 31 [cited 2024 Oct. 5];13(4):23-5. Available from: https://pjp.pps.org.pk/index.php/PJP/article/view/283