Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Cochrane On Bisphosphonates for Prostate Cancer

Cochrane; 2017 Dec 26; Macherey, Monsef, et al

Men with bone metastases from prostate who took bisphosphonates or control regimens experienced similar responses to pain, according to a Cochrane review of 18 clinical trials. The reviews found that bisphosphonates:

  • Provided no clinically relevant difference in pain response vs placebo or no additional treatment, based on low quality evidence.
  • Reduced pain in 40 more men/1,000.
  • Appear to result in 58 fewer skeletal-related events/1,000.
  • Showed no clear difference in the number of men who died or took fewer pain killers.
  • Probably increased the number of men with nausea, based on moderate quality evidence.
  • Probably increased the number of men with kidney problems, based on moderate quality evidence.
  • Showed no clear difference in patients who experienced osteonecrosis of the jaw, based on very low quality evidence.
  • Probably decreased the number of men affected by disease progression, according to moderate quality evidence.


Macherey S, Monsef I, Jahn F, et al. Bisphosphonates for advanced prostate cancer. Cochrane Database of Syst Rev. 2017, Issue 12. Art. No.: CD006250. doi:10.1002/14651858.CD006250.pub2.

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