Reply to S.M. Sorscher et al

Abstract

5. Zaghloul MS, Boutrus R, El-Hossieny H, et al: A prospective, randomized, placebo-controlled trial of zoledronic acid in bony metastatic bladder cancer. Int J Clin Oncol 15:382-389, 2010 6. Morgan GJ, Davies FE, Gregory WM, et al: First-line treatment with zoledronic acid as compared with clodronic acid in multiple myeloma (MRC Myeloma IX): A randomised controlled trial. Lancet 376 :1989-1999, 2010 7. Liu P, Leong T, Quam L, et al: Activating mutations of N-and K-ras in multiple myeloma show different clinical associations:

Incidence of Hypocalcemia in Patients with Post-Menopausal Osteoporosis or Cancer Skeletal Related Events after Denosumab in Comparison to Zoledronic Acid in a Community Hospital Setting

“…The non-calcium adverse effects seen in our study groups were similar to those previously reported [6,8].…”

“…This is similar to previously reported studies [7,8]. The limitation of our study was that we did not have serum calcium levels in all patients within 1-2 weeks following injection when the incidence of hypocalcemia is highest.…”

“…Denosumab has been reported to have a higher incidence of hypocalcemia (5.5-13%) in comparison to zolendronic acid (3.4-6%) [4][5][6][7][8]. We believe that due to controlled clinical settings these clinical trials might not reveal the true incidence of adverse effects of denosumab.…”

The Metastatic Spine Disease Multidisciplinary Working Group Algorithms

“…In a similar study of 1,904 patients with metastatic castrationresistant prostate cancer (CRPC), the median time to first SRE was 20.7 months with denosumab therapy compared with 17.1 months with zoledronic acid (HR, 0.82; 95% CI, 0.71-0.95; p 5 .08 for superiority) [21]. Finally, in a randomized study of 1,776 patients with solid tumors, including non-small cell lung cancer, the median time to first SRE was 20.6 months with denosumab therapy compared with 16.3 months with zoledronic acid (HR, 0.84; 95% CI, 0.71-0.98; p = .0007 for noninferiority; p = .06 for superiority ) [22].…”

“…First-line therapies for pain palliation include oral analgesics and nonpharmacologic interventions for chronic pain [41]. Osteoclast inhibitors and systemic radionuclide therapy are recommended for prevention of skeletal-related events and pain palliation, as indicated [17][18][19][20][21][22].…”