SynthesisJournal of orthopaedic surgery and research2021
Comparison of denosumab and zoledronic acid for the treatment of solid tumors and multiple myeloma with bone metastasis: a systematic review and meta-analysis based on randomized controlled trials.
Synthesis in Journal of orthopaedic surgery and research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- The 2024 revised clinical guidelines on the management of thyroid tumors by the Japan Association of Endocrine Surgery.Endocrine journal · 2025Guideline
- Article
- [Expert consensus on perioperative management of tooth extraction in patients receiving denosumab therapy].Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology · 2026Article
- Research Progress on Signaling Pathways in Breast Cancer Bone Metastasis.Oncology research · 2026Review
- Mining the FAERS database reveals new safety signals for 120 mg denosumab in oncology practice.PloS one · 2026Article
- Cardiovascular adverse events associated with denosumab versus zoledronic acid in patients with breast cancer: a propensity score overlap weighted analysis.Breast cancer research and treatment · 2025Article
- Imbalance of Serum Bone-Metabolism-Related Factors Associated with Osteonecrosis of the Jaw.Biomedicines · 2025Article
- What is the appropriate antibiotic administration to prevent MRONJ development after tooth extraction?Journal of bone and mineral metabolism · 2025Article
- Impact of treatment delay of multiple myeloma bone disease on later myeloma-related skeletal events and outcome.Journal of bone oncology · 2025Article
- Comparative efficacy of bone-modifying agents in the treatment of lung cancer bone metastases: immunotherapy era.Future oncology (London, England) · 2025Article
- Comparison of the effects of zoledronic acid versus denosumab on bone metabolism, inflammatory response, and immunoglobulins in breast cancer patients with bone metastases.Journal of medical biochemistry · 2025Article
- Usefulness of local therapy for distant metastases of differentiated thyroid cancer.European thyroid journal · 2025Review
- Biomarker-Driven Approaches to Bone Metastases: From Molecular Mechanisms to Clinical Applications.Biomedicines · 2025Review
- Review
- The effect of denosumab vs. zoledronic acid in preventing skeletal-related events, including pain-related bone metastasis: a systematic review.Postepy psychiatrii neurologii · 2024Review
- Remineralization of lytic spinal metastases after radiation therapy - A retrospective cohort study comparing conventional external beam radiation therapy with stereotactic ablative body radiation.Clinical and translational radiation oncology · 2024Article
- Imaging aspects of maxillomandibular bone alterations in patients with multiple myeloma treated with bisphosphonates: A systematic review.Imaging science in dentistry · 2024Review
- Spinal Metastases of the Vertebrae: Three Main Categories of Pain.Life (Basel, Switzerland) · 2024Review
- What Is the Appropriate Antibiotic Administration During Tooth Extractions in Patients Receiving High-Dose Denosumab?Cureus · 2024Article
- Bone health and body composition in prostate cancer: Meet-URO and AIOM consensus about prevention and management strategies.ESMO open · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the efficacy and safety between denosumab and zoledronic acid for advanced cancer with bone metastasis.
methodsMEDLINE, EMBASE, and the Cochrane library databases were searched for randomized controlled trials up to December 2020 that compared denosumab and zoledronic acid in the treatment of advanced cancer with bone metastasis. The following clinical outcomes were extracted for analysis: time to first skeletal-related event, time to first-and-subsequent skeletal-related events, overall survival, and disease progression. Safety outcomes including incidence of adverse events, serious adverse events, acute-phase reactions, renal toxicity, osteonecrosis of the jaw, and hypocalcemia were also extracted.
resultsFour randomized controlled trials involving 7201 patients were included. The overall analysis showed that denosumab was superior to zoledronic acid in delaying time to first skeletal-related event (hazard ratio = 0.86; 95% confidence interval, 0.80-0.93; P < 0.01) and time to first-and-subsequent skeletal-related events (risk ratio 0.87; 95% confidence interval 0.81-0.93; P < 0.01). Denosumab was associated with lower incidence of renal toxicity (risk ratio 0.69; 95% confidence interval 0.54-0.87; P < 0.01) and acute phase reaction (risk ratio 0.47; 95% confidence interval 0.38-0.56; P < 0.01), but higher incidence of hypocalcemia (risk ratio 1.78; 95% confidence interval 1.33-2.38; P < 0.01) and osteonecrosis of the jaw (risk ratio 1.41; 95% confidence interval 1.01-1.95; P = 0.04). No significant differences were found in overall survival, time to disease progression, or incidence of adverse events and serious adverse events between denosumab and zoledronic acid.
conclusionsCompared with zoledronic acid, denosumab is associated with delayed first-and-subsequent skeletal-related events, lower incidence of renal toxicity, and acute phase reaction, but higher incidence of hypocalcemia and osteonecrosis of the jaw. Hence, denosumab seems to be a promising choice for advanced cancer with bone metastasis. Nonetheless, more randomized controlled trials are needed for further evaluation.
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Registered trials
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.