Evidence map›Paper›PMID 25781025›Full record

Trial reportPloS one2015

A randomised controlled trial of intravenous zoledronic acid in malignant pleural disease: a proof of principle pilot study.

Amelia O Clive, Clare E Hooper, Anthony J Edey, Anna J Morley, Natalie Zahan-Evans, David Hall, Iain Lyburn, Paul White, Jeremy P Braybrooke, Iara Sequeiros and 4 more

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 25% of its field
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

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Article
  3. Review
  4. 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

14 authors at 6 institutions in 1 country.

Amelia O CliveAcademic Respiratory Unit, University of Bristol, Bristol, United Kingdom; North Bristol Lung Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom.
Clare E HooperAcademic Respiratory Unit, University of Bristol, Bristol, United Kingdom; North Bristol Lung Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom.
Anthony J EdeyNorth Bristol Lung Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom.
Anna J MorleyNorth Bristol Lung Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom.
Natalie Zahan-EvansNorth Bristol Lung Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom.
David HallCobalt Health, Cheltenham, United Kingdom.
Iain LyburnCobalt Health, Cheltenham, United Kingdom.
Paul WhiteDepartment of Statistics, University of West of England, Bristol, United Kingdom.
Jeremy P BraybrookeBristol Cancer Institute, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom.
Iara SequeirosNorth Bristol Lung Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom.
Stephen M LyenNorth Bristol Lung Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom.
Tim MiltonDepartment of Oral and Maxillofacial Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom.
Brennan C KahanPragmatic Clinical Trials Unit, Queen Mary University of London, London, United Kingdom.
Nick A MaskellAcademic Respiratory Unit, University of Bristol, Bristol, United Kingdom; North Bristol Lung Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom.
North Bristol NHS Trust · GBSouthmead Hospital · GBCobalt Institute · GBUniversity Hospitals Bristol NHS Foundation Trust · GBQueen Mary University of London · GBUniversity of the West of England · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAnimal studies have shown Zoledronic Acid (ZA) may diminish pleural fluid accumulation and tumour bulk in malignant pleural disease (MPD). We performed a pilot study to evaluate its effects in humans.

methodsWe undertook a single centre, double-blind, placebo-controlled trial in adults with MPD. Patients were randomised (1:1) to receive 2 doses of intravenous ZA or placebo, 3 weeks apart and were followed-up for 6 weeks. The co-primary outcomes were change in Visual Analogue Scale (VAS) score measured breathlessness during trial follow-up and change in the initial area under the curve (iAUC) on thoracic Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE-MRI) from randomisation to week 5. Multiple secondary endpoints were also evaluated.

resultsBetween January 2010 and May 2013, 30 patients were enrolled, 24 randomised and 4 withdrew after randomisation (1 withdrew consent; 3 had a clinical decline). At baseline, the ZA group were more breathless, had more advanced disease on radiology and worse quality of life than the placebo group. There was no significant difference between the groups with regards change in breathlessness (Adjusted mean difference (AMD) 4.16 (95%CI -4.7 to 13.0)) or change in DCE-MRI iAUC (AMD -15.4 (95%CI -58.1 to 27.3). Two of nine (22%) in the ZA arm had a >10% improvement by modified RECIST (vs 0/11 who received placebo). There was no significant difference in quality of life measured by the QLQ-C30 score (global QOL: AMD -4.1 (-13.0 to 4.9)), side effects or serious adverse event rates.

conclusionsThis is the first human study to evaluate ZA in MPD. The study is limited by small numbers and imbalanced baseline characteristics. Although no convincing treatment effect was identified, potential benefits for specific subgroups of patients cannot be excluded. This study provides important information regarding the feasibility of future trials to evaluate the effects of ZA further.

trial registrationUK Clinical Research Network ID 8877 ISRCTN17030426 www.isrctn.com.

Indexed as

Administration, IntravenousAgedBiomarkersDiphosphonatesDyspneaFemaleHumansImidazolesMaleNeoplasm MetastasisPilot ProjectsPleuraPleural Effusion, MalignantQuality of LifeSafetyTreatment OutcomeBiomarkersDiphosphonatesImidazolesZoledronic Acid

Identifiers

PMID25781025
PMCPMC4364455
OpenAlexW2072534995

What OpenQuestion holds

Textmetadata
LicenceCC BY
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 OpenQuestion graph.