Analgesic efficacy of zoledronic acid and its effect on functional status of prostate cancer patients with metastasis

Original Research

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Authors: Rafael Gálvez, Victoria Ribera, José Ramón González-Escalada, Alicia Souto, María Luz Cánovas, et al

Published Date August 2008 Volume 2008:2 Pages 215 - 224

DOI: http://dx.doi.org/10.2147/PPA.S2314

Rafael Gálvez¹, Victoria Ribera², José Ramón González-Escalada³, Alicia Souto⁴, María Luz Cánovas⁴, Andrés Castro⁴, Begoña Herrero⁵, María de los Ángeles Maqueda⁵, Matilde Castilforte⁶, José Javier Marco-Martínez⁷, Concepción Pérez⁸, Lorenza Vicente-Fatela⁹, Consuelo Nieto MD¹⁰, Maria José Orduña¹¹, Anna Padrol¹², Enrique Reig¹³, Joaquín Carballido¹⁴, José Manuel Cózar¹⁵

¹Pain and Palliative Care Unit, Hospital Universitario Virgen de las Nieves, Granada, Spain; ²Pain Unit, Hospital Vall d’Hebron, Barcelona, Spain; ³Pain Unit, Hospital Ramón y Cajal, Madrid, Spain; ⁴Pain Unit, Hospital Cristal Piñor, Ourense, Spain; ⁵Pain Unit, Hospital Virgen de la Macarena, Sevilla, Spain; ⁶Pain Unit, Fundación Jiménez Díaz, Madrid, Spain; ⁷Pain Unit, Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain; ⁸Pain Unit, Hospital La Princesa, Madrid, Spain; ⁹Pain Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; ¹⁰Pain Unit, Fundación Alcorcón, Madrid, Spain; ¹¹Pain Unit, Hospital Xeral-Calde, Lugo, Spain; ¹²Pain Unit, Hospital Joan XXIII, Tarragona, Spain; ¹³Pain Unit, Hospital Puerta del Hierro, Madrid, Spain; ¹⁴Urology Service, Hospital Puerta del Hierro, Madrid, Spain; ¹⁵Urology Service, Hospital Universitario Virgen de las Nieves, Granada, Spain

Objectives: A multi-centered observational study evaluated the efficacy of zoledronic acid for improving pain and mobility, and preventing skeletal-related events (SRE) (fracture, spinal compression, pain-relieving radiotherapy), in patients with prostate cancer and bone metastasis.

Materials and Methods: Males (n = 218) with prostate cancer and bone metastasis undergoing oncologic therapy received zoledronic acid (4 mg iv/month) for 6 months. Parameters evaluated were: 1) pain and movement after 2 consecutive doses; 2) quality of life; 3) SRE incidence and time-to-appearance. Medication tolerance and treatment satisfaction were assessed using a questionnaire.

Results: A total of 170 that matched all the inclusion criteria (78%) out of 218 were evaluable for efficacy. There was a measurable statistically significant reduction in pain at rest and on movement as well as an improvement in the quality of life compared with baseline. Best results were obtained with early treatment. Overall incidence of bone events was 11.2%. Of the 212 patients (97.2%) evaluable for safety, 16% suffered adverse events and 66% expressed satisfaction with the treatment

Discussion: Zoledronic acid is effective for reducing pain, improving mobility, and increasing the quality of life in patients with prostate cancer with bone metastasis. Its easy administration and good tolerability make zoledronic acid one of the principal therapeutic tools in the management of patients with pain associated with bone metastasis from prostate cancer.

Keywords: bone metastasis, pain, prostate cancer, zoledronic acid

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