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Zoledronic acid and skeletal-related events in patients with bone metastatic cancer or multiple myeloma.

骨转移癌或多发性骨髓瘤患者的唑来膦酸和骨骼相关事件。

  • 影响因子:2.29
  • DOI:10.1007/s00774-019-01052-6
  • 作者列表:"Jeon HL","Oh IS","Baek YH","Yang H","Park J","Hong S","Shin JY
  • 发表时间:2020-03-01
Abstract

INTRODUCTION:Investigations of ZA effectiveness using large, real-world databases are rare. We examined whether zoledronic acid (ZA) decreased the risk of skeletal-related events (SREs) among patients with bone metastases (BMs) from breast cancer (BC) or prostate cancer (PC), or multiple myeloma (MM) in routine clinical practice. MATERIALS AND METHODS:We conducted a propensity score-matched cohort study using the Korean National Health Insurance database. Our cohort included patients diagnosed with BM after BC or PC, or MM between 2004 and 2015. SRE was defined as having a record of pathologic fracture, spinal cord compression, radiation, or surgery to bone. The incidence of multiple SREs was calculated according to SRE history. We calculated the incidence rate ratio (IRR) to examine the relative difference in the risk of SREs of ZA users compared to those of ZA non-user. RESULTS:Among 111,679 patients, diagnosed with BM and one of the three cancer types, 5608 were included in the analysis after propensity score matching. A decreased risk of SREs was observed for the ZA use in patients with history of SRE in BC [IRR = 0.74, 95% confidence interval (CI) = 0.66-0.83], PC (IRR = 0.86, 95% CI = 0.73-1.02), and MM (IRR = 0.74, 95% CI = 0.59-0.93). For patients without SRE history, ZA use was not associated with decreased risks of SREs, but rather increased the risks (BC: IRR = 1.96, 95% CI 1.87-2.05; PC: IRR = 1.66, 95% CI 1.54-1.80; MM: IRR = 1.92, 95% CI 1.57-2.34). CONCLUSIONS:Our study suggests that the ZA use was associated with a decreased risk of SRE for patients with SRE history. However, no preventive effects of ZA were observed for patients without history.

摘要

简介: 使用大型真实世界数据库对ZA有效性进行的调查很少。我们检测了唑来膦酸 (ZA) 是否降低乳腺癌 (BC) 或前列腺癌 (PC) 骨转移 (BMs) 患者骨相关事件 (SREs) 的风险。或多发性骨髓瘤 (MM) 在常规临床实践。 材料和方法: 我们使用韩国国民健康保险数据库进行了一项倾向评分匹配的队列研究。我们的队列包括BC或PC后诊断为BM的患者,或 2004 年至 2015 年间的MM。SRE定义为有病理性骨折、脊髓压迫、放疗或骨手术记录。根据SRE病史计算多发性SREs的发生率。我们计算了发病率比 (IRR),以检验ZA使用者与ZA非使用者相比SREs风险的相对差异。 结果: 在 111,679 例被诊断为BM和三种癌症类型之一的患者中,5608 例被纳入倾向评分匹配后的分析。在BC中有SRE病史的患者中观察到ZA使用SREs的风险降低 [irr = 0.74,95% 置信区间 (CI) = 0.66-0.83],PC (irr = 0.86,95% ci = 0.73-1.02) 和MM (irr = 0.74,95% ci = 0.59-0.93)。对于无SRE病史的患者,使用ZA与SRE风险降低无关,而是增加了风险 (BC: irr = 1.96,95% CI 1.87-2.05; PC: irr = 1.66,95% CI 1.54-1.80; MM: irr = 1.92,95% CI 1.57-2.34)。 结论: 我们的研究表明,ZA的使用与有SRE病史的患者SRE风险降低相关。然而,对于无病史的患者,未观察到ZA的预防作用。

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骨肿瘤方向

骨肿瘤是发生于骨骼或其附属组织的肿瘤。有良性,恶性之分,良性骨肿瘤易根治,预后良好,恶性骨肿瘤发展迅速,预后不佳,死亡率高。

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