Pamidronate is superior to ibandronate in decreasing bone resorption, interleukin-6 and β₂ -microglobulin in multiple myeloma.

Terpos, Evangelos; Viniou, Nora; de la Fuente, Josu; Meletis, John; Voskaridou, Ersi; Karkantaris, Christos; Vaiopoulos, George; Palermos, John; Yataganas, Xenophon; Goldman, John M; Rahemtulla, Amin

Abstract: Objectives: Bisphosphonates have been found to reduce skeletal events in patients with multiple myeloma (MM). This is the first randomised trial to compare the efficacy of pamidronate and ibandronate, a third-generation aminobisphosphonate, in bone turnover and disease activity in MM patients. Methods: Patients with MM, stage II or III, were randomly assigned to receive either pamidronate 90 mg (group I: 23 patients) or ibandronate 4 mg (group II: 21 patients) as a monthly intravenous infusion in addition to conventional chemotherapy. Skeletal events, such as pathologic fractures, hypercalcaemia, and bone radiotherapy were analysed. Bone resorption markers [N -terminal cross-linking telopeptide of type-I collagen (NTX) and tartrate-resistant acid phosphatase type 5b (TRACP-5b)], bone formation markers (bone alkaline phosphatase and osteocalcin), markers of disease activity (paraprotein, CRP, β2 -microglobulin), and interleukin-6 (IL-6) were also studied. Results: In both groups, the combination of chemotherapy with either pamidronate or ibandronate produced a reduction in bone resorption and tumour burden as measured by NTX, IL-6, paraprotein, CRP, and β2 -microglobulin from the second month of treatment, having no effect on bone formation. TRACP-5b also had a significant reduction in the pamidronate group from the second month of treatment and in the ibandronate group from the sixth month. However, there was a greater reduction of NTX, IL-6, and β2 -microglobulin in group I than in group II, starting at the second month of treatment (P = 0.002, 0.001, and 0.004, respectively) and of TRACP-5b, starting at the fourth month (P = 0.014), that being continued throughout the 10-month follow-up of this study. There was no difference in skeletal events during this period. A significant correlation was observed between changes of NTX and changes of TRACP-5b, IL-6, and β2 -microglobulin from the...

MULTIPLE myeloma treatment; DISODIUM pamidronate; INTERLEUKIN-6

European Journal of Haematology, 2003, Vol 70, Issue 1, p34

0902-4441

Academic Journal

10.1034/j.1600-0609.2003.02823.x