Abstract
Background Zoledronic acid (ZA) is an intravenous bisphosphonate approved for the prevention and treatment of cancer skeletal-related events. Objective Our aim was to analyze the prescription patterns of ZA in the cancer outpatient clinic. Method We performed a retrospective chart review of all patients who received at least 1 dose of ZA from January 2009 until December 2010 in our institution. The patients’ follow-up period was defined from the administration of the first dose until February 2011. Results The sample comprised 345 patients: 31.9 % had breast cancer, 14.5 % prostate cancer, 29.0 % multiple myeloma, and 24.6 % other solid tumors. A total of 4,546 doses were administered; 2,749 (60.5 %) without intravenous chemotherapy. 71.1 % of patients with breast cancer, 86 % with prostate cancer, 60 % with multiple myeloma and 44.6 % with other solid tumors, received ZA without intravenous chemotherapy throughout bisphosphonate treatment. Doses were adjusted in one-third of cases. Administration every 4-weeks was the most frequent schedule. Median duration of treatment varied between 15.0 months for breast cancer and 4.2 months for other solid tumors. Conclusion Most of ZA prescriptions in cancer outpatients followed the labeled indications. The percentage of ZA doses administered without intravenous chemotherapy was 60.5 %.
References
Aapro M, Abrahamsson PA, Body JJ, Coleman RE, Colomer R, Costa L, et al. Guidance on the use of bisphosphonates in solid tumours: recommendations of an international expert panel. Ann Oncol. 2008;19(3):420–32.
Hillner BE, Ingle JN, Chlebowski RT, Gralow J, Yee GC, Janjan NA, et al. American Society of Clinical Oncology 2003 update on the role of bisphosphonates and bone health issues in women with breast cancer. J Clin Oncol. 2003;21(21):4042–57.
Tanvetyanon T, Stiff PJ. Management of the adverse effects associated with intravenous bisphosphonates. Ann Oncol. 2006;17(6):897–907.
Hoer A, Goethe H, Barghout V, et al. Low persistency with oral bisphosphonates in cancer patients [poster]. Presented at: 5th European Oncology Nursing Society Spring Convention; April 20–22, 2006; Innsbruck, Austria. Abstract 2.
European Medicines Agency. Zometa (zoledronic acid) summary of product characteristics [online]. Available from URL: http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000336/WC500051730.pdf. Accessed 30 Oct 2011.
Hoffmann F, Jung TI, Felsenberg D, Glaeske G. Pattern of intravenous bisphosphonate use in outpatient care in Germany. Pharmacoepidemiol Drug Saf. 2008;17(9):896–903.
Wardley A, Davidson N, Barrett-Lee P, Hong A, Mansi J, Dodwell D, et al. Zoledronic acid significantly improves pain scores and quality of life in breast cancer patients with bone metastases: a randomised, crossover study of community vs hospital bisphosphonate administration. Br J Cancer. 2005;92(10):1869–76.
Marr HK, Stiles CR, Boyar MA, Braun TC, Hagen NA, Janzen C, et al. Feasibility of administering zoledronic acid in palliative patients being cared for in the community: results of a pilot study. Curr Oncol. 2010;17(2):69–74.
Tassinari D, Poggi B, Nicoletti S, Fantini M, Tamburini E, Possenti C, et al. Zoledronic acid treatment at home: safety data from an observational prospective trial. J Palliat Med. 2007;10(2):352–8.
Rodriguez-Penin I, Lamas MJ, Iglesias-Santamaria A, Lema M, Bernardez B, Gonzalez-Pereira E, et al. Retrospective epidemiologic study to evaluate the pattern of use of biphosphonates in the treatment of bone metastasis in solid tumor cancer patients (REBIUS) [poster]. J Clin Oncol. 2010 Jun, 14 (28) (suppl; abstr e19667).
Funding
None.
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Anglada-Martínez, H., do Pazo-Oubiña, F., Molas-Ferrer, G. et al. Prescribing of zoledronic acid in a tertiary outpatient hospital setting. Int J Clin Pharm 34, 832–836 (2012). https://doi.org/10.1007/s11096-012-9693-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11096-012-9693-4