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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.

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Authors+Show Affiliations

de Lemos ML
Provincial Systemic Therapy Program, British Columbia Cancer Agency, Vancouver, BC, Canada. mdelemos@bccancer.bc.ca
Taylor SC
No affiliation info available
Barnett JB
No affiliation info available
Hu F
No affiliation info available
Levin A
No affiliation info available
Moravan V
No affiliation info available
O'Reilly SE
No affiliation info available

MeSH

AgedAntineoplastic AgentsBreast NeoplasmsClinical Trials as TopicCost-Benefit AnalysisCreatinineDiphosphonatesDrug Administration ScheduleDrug CostsFemaleHealth Care CostsHumansImidazolesInfusions, IntravenousKidney DiseasesMaleMiddle AgedMultiple MyelomaPamidronatePrevalenceRegistriesRetrospective StudiesTreatment OutcomeZoledronic Acid

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 -