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Comparative effectiveness on survival of zoledronic acid versus pamidronate in multiple myeloma
Journal article   Open access   Peer reviewed

Comparative effectiveness on survival of zoledronic acid versus pamidronate in multiple myeloma

K. M. Sanfilippo, B. Gage, S. Luo, K. Weilbaecher, M. Tomasson, R. Vij, G. Colditz and K. Carson
Leukemia & lymphoma, Vol.56(3), pp.615-621
03/2015
DOI: 10.3109/10428194.2014.924117
PMCID: PMC4399231
PMID: 24844358
url
https://www.ncbi.nlm.nih.gov/pmc/articles/4399231View
Open Access

Abstract

Abstract Zoledronic acid and pamidronate are the two bisphosphonates approved in the United States to reduce multiple myeloma skeletal complications. Little prior evidence exists comparing survival outcomes between the two. We evaluated the incidence of skeletal-related events and overall survival in patients with myeloma treated with zoledronic acid versus pamidronate using a cohort of 1018 United States veterans. At a median follow-up of 26.9 months, patients receiving zoledronic acid had a 22% reduction in risk of death compared to pamidronate (hazard ratio 0.78; 95% confidence interval, 0.67-0.92). The benefit persisted after controlling for potential confounders. Adjusted Cox modeling with inverse probability weighting and propensity score matching supported these findings. Zoledronic acid was also associated with a 25% decrease in skeletal-related events. Zoledronic acid is associated with increased overall survival and decreased skeletal-related events compared to pamidronate in patients with multiple myeloma and should become the preferred bisphosphonate.

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