1 40 1 Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Citation List Month Backlog URL Address <a href="http://doi.org/10.1002/14651858.cd002068" target="_blank" rel="noreferrer">http://doi.org/10.1002/14651858.cd002068</a> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Bisphosphonates for the relief of pain secondary to bone metastases Publisher An entity responsible for making the resource available Cochrane Database Of Systematic Reviews Date A point or period of time associated with an event in the lifecycle of the resource 2002 Subject The topic of the resource Humans; Analgesics; Pain/drug therapy; Non-Narcotic/therapeutic use; Antineoplastic Agents/therapeutic use; Bone Neoplasms/complications/drug therapy/secondary; Clodronate; Clodronic Acid/therapeutic use; Diphosphonates/therapeutic use; Etidronic Acid/therapeutic use; Randomized Controlled Trials Creator An entity primarily responsible for making the resource Wong R; Wiffen PJ Description An account of the resource BACKGROUND: Bisphosphonates form part of standard therapy for hypercalcemia and the prevention of skeletal events in some cancers. However, the role of bisphosphonates in pain relief for bony metastases remains uncertain. OBJECTIVES: To determine the effectiveness of bisphosphonates for the relief of pain from bone metastases. SEARCH STRATEGY: MEDLINE (1966-1999), EMBASE (1980-1999), CancerLit (1966-1999), the Cochrane library (Issue 1, 2000) and the Oxford Pain Database were searched using the strategy devised by the Cochrane Pain, Palliative and Supportive Care Group with additional terms 'diphosphonate', 'bisphosphonate', 'multiple myeloma' and 'bone neoplasms'. (Last search: January 2000). SELECTION CRITERIA: Randomized trials of bisphosphonates compared with open, blinded, or different doses/types of bisphosphonates in cancer patients were included where pain and/or analgesic consumption were outcome measures. Studies where pain was reported only by observers were excluded. DATA COLLECTION AND ANALYSIS: Article eligibility, quality assessment and data extraction were undertaken by both reviewers. The proportions of patients with pain relief at 4, 8 and 12 weeks were assessed. The proportion of patients with analgesic reduction, the mean pain score, mean analgesic consumption, adverse drug reactions, and quality of life data were compared as secondary outcomes. MAIN RESULTS: Thirty randomized controlled studies (21 blinded, four open and five active control) with a total of 3682 subjects were included. For each outcome, there were few studies with available data. For the proportion of patients with pain relief (eight studies) pooled data showed benefits for the treatment group, with an NNT at 4 weeks of 11[95% CI 6-36] and at 12 weeks of 7 [95% CI 5-12]. In terms of adverse drug reactions, the NNH was 16 [95% CI 12-27] for discontinuation of therapy. Nausea and vomiting were reported in 24 studies with a non-significant trend for greater risk in the treatment group. One study showed a small improvement in quality of life for the treatment group at 4 weeks. The small number of studies in each subgroup with relevant data limited our ability to explore the most effective bisphosphonates and their relative effectiveness for different primary neoplasms. REVIEWER'S CONCLUSIONS: There is evidence to support the effectiveness of bisphosphonates in providing some pain relief for bone metastases. There is insufficient evidence to recommend bisphosphonates for immediate effect; as first line therapy; to define the most effective bisphosphonates or their relative effectiveness for different primary neoplasms. Bisphosphonates should be considered where analgesics and/or radiotherapy are inadequate for the management of painful bone metastases. 2002 Identifier An unambiguous reference to the resource within a given context <a href="http://doi.org/10.1002/14651858.cd002068" target="_blank" rel="noreferrer">10.1002/14651858.cd002068</a> Rights Information about rights held in and over the resource Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s). Type The nature or genre of the resource Journal Article 2002 Analgesics Antineoplastic Agents/therapeutic use Backlog Bone Neoplasms/complications/drug therapy/secondary Clodronate Clodronic Acid/therapeutic use Cochrane Database of Systematic Reviews Diphosphonates/therapeutic use Etidronic Acid/therapeutic use Humans Journal Article Non-Narcotic/therapeutic use Pain/drug Therapy Randomized Controlled Trials Wiffen PJ Wong R