Men with bone metastases had reductions in pain and skeletal-related events with acid use.

ORLANDO—Zoledronic acid provides long-term reduction of pain and risk of skeletal-related events (SREs) in men with bone metastases secondary to prostate cancer.

Researchers studied 422 men who were randomized to receive 4 mg zoledronic acid (Zometa) or placebo every three weeks for up to 24 months. Among 101 of the 371 evaluable patients who had no pain at baseline, mean pain scores rose slightly in both zoledronic acid and placebo arms, but the patients treated with zoledronic acid consistently reported smaller in-creases compared with placebo recipients. Among patients with pain at baseline, zoledronic acid decreased pain scores from baseline whereas placebo patients had an increase in pain scores.

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The study, led by Fred Saad, MD, of the Centre Hospitalier de l’Université de Montréal, found that among men with pain at baseline, zoledronic acid reduced the mean annual incidence of SREs by 39% compared with placebo; among men with no pain, zoledronic acid reduced the mean annual incidence of SREs by 49%. Zoledronic acid decreased the incidence of SREs regardless of the number of bone metastases at baseline, although these reductions were greater in men with three or fewer metastases.

“Taken together, these results suggest that earlier intervention with zoledronic acid may improve clinical outcomes,” the authors wrote.

SREs are defined as pathologic fracture, spinal cord compression, bone surgery, radiation therapy to bone, hypercalcemia of malignancy, or a change in antineoplastic therapy to treat bone pain.