Evidence map›Paper›PMID 29387997›Full record

SynthesisSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2018

Denosumab versus bisphosphonates in patients with advanced cancers-related bone metastasis: systematic review and meta-analysis of randomized controlled trials.

Amr Menshawy, Omar Mattar, Ali Abdulkarim, Shiref Kasem, Noha Nasreldin, Esraa Menshawy, Salahuddean Mohammed, Mohamed Abdel-Maboud, Mohamed Gadelkarim, Gehad Gamal El Ashal and 1 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Prevalence of medication related osteonecrosis of the jaw in patients treated with sequential antiresorptive drugs: systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Bone health in patients with cancer: a SEOM-SEIOMM consensus review of risk factors, assessment strategies, and management approaches.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
    Review
  7. Article
  8. Article
  9. Multifunctional CuFrontiers in chemistry · 2026
    Review
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Review
  17. Observational
  18. Article
  19. Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Amr MenshawyMedical Research Education and Practice Association (MREP), Cairo, Egypt.
Omar MattarMedical Research Education and Practice Association (MREP), Cairo, Egypt.
Ali AbdulkarimMedical Research Education and Practice Association (MREP), Cairo, Egypt.
Shiref KasemMedical Research Education and Practice Association (MREP), Cairo, Egypt.
Noha NasreldinMedical Research Society, Cairo University, Cairo, Egypt.
Esraa MenshawyMedical Research Education and Practice Association (MREP), Cairo, Egypt.
Salahuddean MohammedMedical Research Society, Cairo University, Cairo, Egypt.
Mohamed Abdel-MaboudMedical Research Education and Practice Association (MREP), Cairo, Egypt.
Mohamed GadelkarimMedical Research Education and Practice Association (MREP), Cairo, Egypt.
Gehad Gamal El AshalMedical Research Education and Practice Association (MREP), Cairo, Egypt.
Ahmed Saber ElgebalyMedical Research Education and Practice Association (MREP), Cairo, Egypt. Ahmedelgebaly94@azhar.edu.eg.ORCID http://orcid.org/0000-0002-8324-0960

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBone metastasis is reported to be associated with poor quality of life, and increased risk of hospitalization. We aim to synthesize evidence from published randomized controlled trials (RCTs) which compared the efficacy of denosumab versus bisphosphonates in patients with advanced cancers.

methodsWe searched for all published RCTs in the following electronic databases: PubMed, Scopus, Web of Science, and Cochrane Central. Retrieved records were screened for eligibility. Time-to-event data were pooled as hazard ratio (HR) using the generic inverse-variance method and dichotomous data were pooled as relative risk (RR) in a random-effect model. We used Review Manager 5.3 for windows.

resultsSix unique RCTs with a total of 7722 patients were included. Overall effect estimates favored denosumab group in comparison to intravenous (IV) bisphosphonates in the following terms: time to first skeletal-related events (HR 0.92, 95% CI [0.86, 0.98], p = 0.01), time to subsequent skeletal-related event (RR 0.92, 95% CI [0.86, 0.99], p = 0.03), and radiation to bone (RR 0.81, 95% CI [0.71, 0.92], p = 0.02). Denosumab group was associated with increased risk of grade 3 or 4 hypocalcaemia (RR 1.99, 95% CI [1.11, 3.54], p = 0.02) and reduced risk of renal impairment or toxicity (RR 0.75, 95% CI [0.61, 0.91], p = 0.003) in comparison to IV bisphosphonates group. Pooled studies were homogenous.

conclusionDenosumab showed a favorable significant impact on delaying the time to first skeletal-related event and reducing the incidence of radiation to the bone event in comparison to bisphosphonates, with similar efficacy regarding overall survival and time to disease progression. Further large-scale and long-term studies are needed to clarify the long-term efficacy and safety of both regimens.

Indexed as

Bone Density Conservation AgentsBone NeoplasmsDenosumabDiphosphonatesHumansQuality of LifeRandomized Controlled Trials as TopicBone Density Conservation AgentsDenosumabDiphosphonatesBone metastasesDenosumabSkeletal-related eventZoledronic acid

Identifiers

PMID29387997

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.