Effects of zoledronic acid on metastatic bone pain in cancer of the prostate: A randomised controlled trial

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MO Akinwale
OA Soyannwo
OO Aikomo
AT Orunmuyi
B Kolude
EO Olapade-Olaopa

Resumo

Background: Advanced cancer of the prostate often


causes pain that can be severe requiring palliation


with analgesics. Zoledronic acid, a third-generation


bisphosphonate, has not been primarily used as an


adjunct to treat pain in patients with metastatic bone


secondary to advanced prostate cancer in Nigeria.


The study investigated the effects of 3 doses of


Zoledronic acid, at 4-weekly intervals, in addition to


the analgesic regimen of oral morphine, diclofenac,


paracetamol and amitriptyline, on bone pain in patients


with metastatic prostate cancer .


Methods: A prospective randomized open-labelled


trial in which forty patients with moderate to severe


bone pain due to metastatic prostate cancer were


recruited after institutional ethics approval. Patients


were assigned to two groups: The Control (C) group


received liquid oral morphine, diclofenac, paracetamol


and amitriptyline. Zoledronic acid (ZG) group received


3 doses of Zoledronic acid at 4-weekly intervals in


addition to liquid morphine, diclofenac, paracetamol and


amitriptyline. Severity of pain and quality of life (QoL)


were measured at baseline and weekly for 12 weeks.


Data were analysed using means, range, standard


deviations and proportions while independent t-test was


used to compare the variables between the two groups.


Results: Demographic variables, baseline pain scores


and quality of life between the 2 groups were similar.


There was a statistically significant improvement in


pain score in the Zoledronic acid group (1.38±0.53


vs 2.13±0.94) post-intervention, (p = 0.004).


Conclusion: The administration of three doses of


Zoledronic acid at 4-weekly intervals significantly


improved bone pain score during the 12-weeks follow


up in patients with advanced prostate cancer.

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Secção

Original Articles

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