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Renal safety of 1-hour pamidronate infusion for breast cancer and multiple myeloma patients: comparison between clinical trials and population-based database.
J Oncol Pharm Pract. 2006 Dec; 12(4):193-9.JO

Abstract

PURPOSE

The American Society of Clinical Oncology recommends infusion of pamidronate over 2 hours to avoid renal deterioration, although there are data to suggest that 1-hour infusions may be safe.

METHODS

Prevalence of renal deterioration with 1-hour pamidronate infusions from a population database was compared to renal deterioration with 2-hour pamidronate infusions, in randomised, controlled, trials. A cost-minimisation analysis, comparing the 1- and 2-hour pamidronate infusions, and the 15-minute infusion of zoledronic acid, was performed with a sensitivity analysis that varied the opportunity cost of time in the treatment room.

RESULTS

Renal deterioration occurred in 7.7% of 169 patients with multiple myeloma and metastatic breast cancer. There is no evidence that this differs from the 10% reported in randomised, controlled, trials (one-tailed binomial test, P = 0.3874). A subgroup analysis showed that renal deterioration occurred in 15 and 1.1% of patients with multiple myeloma and metastatic breast cancer, respectively. The median increase in serum creatinine was 13 and 7% in the multiple myeloma and breast cancer groups, respectively. The respective costs/dose (drug/labour/supplies) of pamidronate and zoledronic acid are 325 dollars and 610 dollars. Cost neutrality occurs if the opportunity cost of chair time is 6.33 dollars/minute for pamidronate 1-hour versus zoledronic acid, and 2.71 dollars/minute for pamidronate 2-hour versus zoledronic acid. If a median 4 dollars/minute is used, the respective costs of pamidronate 1-hour, 2-hour, and zoledronic acid infusions are 685 dollars, 925 dollars, and 790 dollars/cycle.

CONCLUSIONS

Prevalence of renal deterioration with 1-hour pamidronate infusions from a population database was not significantly different to 2-hour pamidronate infusions in clinical trials. Our findings suggest further support for the safety of 1-hour pamidronate infusions. Pamidronate via 1-hour infusion is less expensive than zoledronic acid.

Authors+Show Affiliations

Provincial Systemic Therapy Program, British Columbia Cancer Agency, Vancouver, BC, Canada. mdelemos@bccancer.bc.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17156591

Citation

de Lemos, Mário L., et al. "Renal Safety of 1-hour Pamidronate Infusion for Breast Cancer and Multiple Myeloma Patients: Comparison Between Clinical Trials and Population-based Database." Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners, vol. 12, no. 4, 2006, pp. 193-9.
de Lemos ML, Taylor SC, Barnett JB, et al. Renal safety of 1-hour pamidronate infusion for breast cancer and multiple myeloma patients: comparison between clinical trials and population-based database. J Oncol Pharm Pract. 2006;12(4):193-9.
de Lemos, M. L., Taylor, S. C., Barnett, J. B., Hu, F., Levin, A., Moravan, V., & O'Reilly, S. E. (2006). Renal safety of 1-hour pamidronate infusion for breast cancer and multiple myeloma patients: comparison between clinical trials and population-based database. Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners, 12(4), 193-9.
de Lemos ML, et al. Renal Safety of 1-hour Pamidronate Infusion for Breast Cancer and Multiple Myeloma Patients: Comparison Between Clinical Trials and Population-based Database. J Oncol Pharm Pract. 2006;12(4):193-9. PubMed PMID: 17156591.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Renal safety of 1-hour pamidronate infusion for breast cancer and multiple myeloma patients: comparison between clinical trials and population-based database. AU - de Lemos,Mário L, AU - Taylor,Suzanne C, AU - Barnett,Jeff B, AU - Hu,Francis, AU - Levin,Adeera, AU - Moravan,Veronika, AU - O'Reilly,Susan E, PY - 2006/12/13/pubmed PY - 2007/3/16/medline PY - 2006/12/13/entrez SP - 193 EP - 9 JF - Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners JO - J Oncol Pharm Pract VL - 12 IS - 4 N2 - PURPOSE: The American Society of Clinical Oncology recommends infusion of pamidronate over 2 hours to avoid renal deterioration, although there are data to suggest that 1-hour infusions may be safe. METHODS: Prevalence of renal deterioration with 1-hour pamidronate infusions from a population database was compared to renal deterioration with 2-hour pamidronate infusions, in randomised, controlled, trials. A cost-minimisation analysis, comparing the 1- and 2-hour pamidronate infusions, and the 15-minute infusion of zoledronic acid, was performed with a sensitivity analysis that varied the opportunity cost of time in the treatment room. RESULTS: Renal deterioration occurred in 7.7% of 169 patients with multiple myeloma and metastatic breast cancer. There is no evidence that this differs from the 10% reported in randomised, controlled, trials (one-tailed binomial test, P = 0.3874). A subgroup analysis showed that renal deterioration occurred in 15 and 1.1% of patients with multiple myeloma and metastatic breast cancer, respectively. The median increase in serum creatinine was 13 and 7% in the multiple myeloma and breast cancer groups, respectively. The respective costs/dose (drug/labour/supplies) of pamidronate and zoledronic acid are 325 dollars and 610 dollars. Cost neutrality occurs if the opportunity cost of chair time is 6.33 dollars/minute for pamidronate 1-hour versus zoledronic acid, and 2.71 dollars/minute for pamidronate 2-hour versus zoledronic acid. If a median 4 dollars/minute is used, the respective costs of pamidronate 1-hour, 2-hour, and zoledronic acid infusions are 685 dollars, 925 dollars, and 790 dollars/cycle. CONCLUSIONS: Prevalence of renal deterioration with 1-hour pamidronate infusions from a population database was not significantly different to 2-hour pamidronate infusions in clinical trials. Our findings suggest further support for the safety of 1-hour pamidronate infusions. Pamidronate via 1-hour infusion is less expensive than zoledronic acid. SN - 1078-1552 UR - https://www.unboundmedicine.com/medline/citation/17156591/Renal_safety_of_1_hour_pamidronate_infusion_for_breast_cancer_and_multiple_myeloma_patients:_comparison_between_clinical_trials_and_population_based_database_ L2 - https://journals.sagepub.com/doi/10.1177/1078155206073520?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -