The effectiveness of zoledronic acid and ibandronic acid as therapy for bone metastases in multiple myeloma: A systematic review

Abstract

Zoledronic acid and ibandronic acid are used in preventing skeletal-related event (SRE) in multiple myeloma (MM). Both drugs were listed in the Indonesian formulary. There was no available head-to-head comparative study, hence the need for a systematic review. The purpose of this systematic review was to describe the effectiveness of intravenous zoledronic and ibandronic acids in preventing SRE. The search for articles was conducted on accessible databases with the potential to provide relevant research material such as PUBMED, EBSCOhost, and ScienceDirect. The articles were limited to randomized controlled trials on both drugs in MM patients, published between 1980 and 2018. The outcomes were SRE, progression-free survival (PFS), overall survival (OS), and adverse event (AE). Thirteen articles were selected. According to the results obtained, the effectiveness of zoledronic acid in preventing SRE was superior to placebo or clodronic acid but not superior to denosumab and pamidronic acid. Ibandronic acid was not superior to placebo or pamidronic acid. The effectiveness of both drugs in preventing SRE was directly proportional to PFS and OS. In conclusion, zoledronic acid was superior to ibandronic acid, but with more occurrence of AE. However, the AE could be reduced by prolonging the duration of the drug use.