Evaluation of safety and analgesic consumption in patients with advanced cancer treated with zoledronic acid

Kmetec, Andrej; Hajdinjak, Tine

doi:10.2478/raon-2013-0041

Cited by 7 publications

(6 citation statements)

References 18 publications

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“…The biological film of VSD can separate the grafted wound from the outside [13,24]. Moreover, continuous negative pressure draining efficiently clears wound exudation in all directions and alters the environment for bacterial growth, leading to effectively preventing bacterial infection because these fluids act as media for bacteria growth and obstacles for capillary growth [21,25]. Above all, we referred that NPWT could lower the infection rate of the microskin transplanted wound in the first several days after skin autografts.…”

Section: Discussionmentioning

confidence: 97%

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Using negative pressure wound therapy on microskin autograft wounds

Zhang

Qiu

et al. 2015

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 97%

“…The visual analog scale (VAS) is widely used in measuring local pain. The patient was asked to indicate his/her perceived pain intensity (most commonly) along a 100-mm horizontal line, and this rating was then measured as the VAS score [20,21].…”

Section: Clinical Criteriamentioning

confidence: 99%

Using negative pressure wound therapy on microskin autograft wounds

Zhang

Qiu

et al. 2015

Journal of Surgical Research

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“…Bisphosphonates are generally well tolerated, although they are occasionally associated with adverse events namely hypocalcemia, nephrotoxicity, pancytopenia and osteonecrosis [ 5 - 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…All bisphosphonates can cause hypocalcemia, regardless of their method of administration, although this is infrequently found to be a clinically symptomatic problem [ 7 , 8 ]. Of note, symptomatic hypocalcemia after ZA is rarely reported.…”

Section: Discussionmentioning

confidence: 99%

Severe resistant hypocalcemia in multiple myeloma after zoledronic acid administration: a case report

Aldave¹,

Jaiswal²

2014

J Med Case Reports

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IntroductionHypercalcemia is one of the most common metabolic abnormalities encountered in any form of malignancy. Hypocalcemia, however, is a rare manifestation, especially in cancers with bone involvement. Here we present a case of hypocalcemia in a patient with multiple myeloma that was refractory to treatment.Case presentationA 73-year-old African American woman recently diagnosed with multiple myeloma, presented with a 2-day history of fever, vomiting and hypocalcemia. Ten days prior to admission she received zoledronic acid, Velcade® (bortezomib), Revlimid® (lenalidomide) and dexamethasone. Treatment was started with intravenous antibiotics and calcium gluconate boluses. After 24 hours of treatment her calcium level became undetectable (<5mg/dL). Continuous intravenous calcium gluconate infusions in addition to boluses were started. She remained persistently hypocalcemic and eventually developed tonic–clonic seizures. Vitamin D levels were found to be low and intravenous paricalcitol was initiated, which improved her calcium level.ConclusionsUnderlying vitamin D deficiency can precipitate severe hypocalcemia in patients with multiple myeloma receiving bisphosphonates. This warrants baseline screening for vitamin D deficiency in these patients.

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“…A 12-month observational study of 125 patients with bone metastases (including 92 patients with prostate cancer) who were receiving zoledronic acid showed that hypocalcaemia of any grade occurred in 18.5% of the patients with prostate cancer. Of patients with any tumour type, hypocalcaemia of grade 3 or 4 occurred in 4% [ 31 ]. The higher incidence of hypocalcaemia encountered in real-world studies compared with clinical trials may reflect poor adherence to guidelines for calcium supplementation and monitoring of patients in clinical practice [ 12 ].…”

Section: Main Textmentioning

confidence: 99%

Hypocalcaemia in patients with prostate cancer treated with a bisphosphonate or denosumab: prevention supports treatment completion

et al. 2018

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BackgroundMost patients with advanced prostate cancer develop bone metastases, which often result in painful and debilitating skeletal-related events. Inhibitors of bone resorption, such as bisphosphonates and denosumab, can each reduce the incidence of skeletal-related events and delay the progression of bone pain. However, these agents are associated with an increased risk of hypocalcaemia, which, although often mild and transient, can be serious and life-threatening. Here we provide practical advice on managing the risk of hypocalcaemia in patients with advanced prostate cancer who are receiving treatment with bone resorption inhibitors. Relevant references for this review were identified through searches of PubMed with the search terms ‘prostate cancer’, ‘bone-targeted agents’, ‘anti-resorptive agents’, ‘bisphosphonates’, ‘zoledronic acid’, ‘denosumab’, ‘hypocalcaemia’, and ‘hypocalcemia’. Additional references were suggested by the authors.Main textAmong patients with advanced cancer receiving a bisphosphonate or denosumab, hypocalcaemia occurs most frequently in those with prostate cancer, although it can occur in patients with any tumour type. Consistent with its greater ability to inhibit bone resorption, denosumab has shown superiority in the prevention of skeletal-related events in patients with bone metastases from solid tumours. Consequently, denosumab is more likely to induce hypocalcaemia than the bisphosphonates. Likewise, various bisphosphonates have differing potencies for the inhibition of bone resorption, and thus the risk of hypocalcaemia varies between different bisphosphonates. Other risk factors for the development of hypocalcaemia include the presence of osteoblastic metastases, vitamin D deficiency, and renal insufficiency. Hypocalcaemia can lead to treatment interruption, but it is both preventable and manageable. Serum calcium concentrations should be measured, and any pre-existing hypocalcaemia should be corrected, before starting treatment with inhibitors of bone resorption. Once treatment has started, concomitant administration of calcium and vitamin D supplements is essential. Calcium concentrations should be monitored during treatment with bisphosphonates or denosumab, particularly in patients at high risk of hypocalcaemia. If hypocalcaemia is diagnosed, patients should receive treatment with calcium and vitamin D.ConclusionWith preventative strategies and treatment, patients with prostate cancer who are at risk of, or who develop, hypocalcaemia should be able to continue to benefit from treatment with bisphosphonates or denosumab.

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Evaluation of safety and analgesic consumption in patients with advanced cancer treated with zoledronic acid

Cited by 7 publications

References 18 publications

Using negative pressure wound therapy on microskin autograft wounds

Using negative pressure wound therapy on microskin autograft wounds

Severe resistant hypocalcemia in multiple myeloma after zoledronic acid administration: a case report

Hypocalcaemia in patients with prostate cancer treated with a bisphosphonate or denosumab: prevention supports treatment completion

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