Heras, P., Hatzopoulos, A., Heras, V., Kritikos, N., Karagiannis, S., & Kritikos, K. (2011). A comparative study of intravenous ibandronate and pamidronate in patients with bone metastases from breast or lung cancer: Effect on metastatic bone pain. American Journal of Therapeutics, 18(5), 340–342.

To compare the effects of ibandronate with those of pamidronate in patients with bone metastases from breast or lung cancer  

All patients were diagnosed with either breast or lung cancer and had scan-confirmed bone metastases. Patients were in one of two treatment groups, each receiving IV medication every four weeks for six months. Group A received 6 mg ibandronate. Group B received 90 mg pamidronate.

• The sample was composed of 25 patients.
• Mean patient age was 60.9 years.
• Of all patients, 28% were male and 72% were female.
• Fifteen participants had a primary diagnosis of breast cancer. Ten participants had a primary diagnosis of lung cancer.

The authors are practitioners at three facilities in Greece: General Hospital of Nafplio, General Hospital of Kos, and the Hellenic Medical Society for the Study of Psychosomatic Problems, Athens. The report does not specify that these were locations used in the study, however.

• Phase of care: active treatment
• Clinical applications: late effects, survivorship, end of life, palliative care
   

Comparative study

• A linear analog scale, 0–10, to assess pain, mobility, and quality of life (QoL)
• Patient's serum calcium-creatinine ratio, to measure bone resorption
   

Patient demographics were similar in both groups. At baseline, linear analog scale scores were similar in both groups. Compared to the pamidronate group, the ibandronate group had lower pain scores, higher mobility and QoL scores, and lower serum calcium levels. Patients who were taking ibandronate needed fewer analgesics (p = 0.001). In regard to bone pain, patients taking ibandronate reported scores in the range 0–1 and patients taking pamidronate reported scores in the range 3–4.

Ibandronate may be superior to pamidronate in alleviating pain, improving mobility and QoL, and reducing bone resorption in patients with bone metastases from breast or lung cancer.

• The study had a small sample size, with fewer than 30 participants.
• The study had a risk of bias due to no random assignment.
   

Evidence from this study strongly supported the effectiveness of bone-modifying agents in reducing the pain of patients with bone metastases. This study attempted to compare the effectiveness of different bisphosphonates. The size and limitations of the trial did not permit researchers to draw firm conclusions regarding the usefulness of one agent over another. Further research is needed to determine the relative efficacy of bone-modifying agents in pain control.