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01.08.2013 | original article | Ausgabe 15-16/2013

Wiener klinische Wochenschrift 15-16/2013

Expert opinion 2011 on the use of new anti-resorptive agents in the prevention of skeletal-related events in metastatic bone disease

Wiener klinische Wochenschrift > Ausgabe 15-16/2013
Rodica Anghel, Alexander Bachmann, Meral Bekşac, Univ. Prof. Dr. Thomas Brodowicz, Jindřich Finek, Radko Komadina, Krzysztof Krzemieniecki, Istvan Lang, Jozef Marencak, Roger von Moos, Martin Pecherstorfer, Tamara Rordorf, Damir Vrbanec, Christoph Zielinski
Wichtige Hinweise
The Skeletal Care Academy Panellists


Bisphosphonates have been a mainstay in the treatment of cancer-related bone disease and have greatly reduced the risk of skeletal complications. More recently, clinical studies suggested additional benefits of denosumab over zoledronic acid in the prevention of skeletal related events. Similar adverse event profiles have been reported for bisphosphonates and denosumab, with infrequent occurrences of osteonecrosis of the jaw with both agents, higher incidence of renal deterioration with zoledronic acid, and higher incidence of hypocalcaemia with denosumab. Based on current evidence, the American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network (NCCN) guidelines do not recommend one drug class over the other in patients with metastatic bone disease. Denosumab, however, may present advantages over bisphosphonates in patients suffering from chronic renal insufficiency. Further research and growing clinical experience will refine the evidence based on which decisions in daily clinical practice can be taken.

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