Rapid health technology assessment of denosumab versus zoledronic acid for bone care in breast cancer
OBJECTIVE To evaluate the advantages and hazards of denosumab vs.zoledronic acid(ZA)in bone protection for breast cancer and provide evidence-based proof for clinical decision-making.METHODS Health technology assessment(HTA)related websites,including PubMed,WanFang,Cochrane Library and CNKI,were systematically searched.The sys-tematic review/Meta-analysis and pharmacoeconomic evaluation on denosumab and ZA for modified bone therapy in breast cancer were included.According to the inclusion and exclusion criteria,two reviewers independently identified the literature,extracted the data and assessed the quality of the included studies,and then performed qualitative description and comparison of the results.RESULTS Six systematic review/Meta and five pharmacoeconomic evaluation were included.Compared with ZA,denosumab was more effective in delaying the time of first occurrence and recurrence of skeletal-related events(SREs),reducing the inci-dence of SREs,and preventing pain in breast cancer with bone metastases.Denosumab reduced the fracture rates in postmeno-pausal breast cancer treated with aromatase inhibitors,while ZA did not show the effect.Compared with ZA,the adverse effects of denosumab were less severe inedema,pyrexia,renal failure and bone pain.However,denosumab may promote the occurrence of osteonecrosis of jaw.Denosumab may have more cost-effectiveness advantages than ZA in domestic and international medical settings.CONCLUSION Compared with ZA,denosumab is safer,more effective and more economical in bone care of breast cancer.
denosumabzoledronic acidfracturebreast cancerrapid health technology assessment
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