Abstract

Bone pain is a frequent complication of metastatic bone disease, with severe consequences for patient mobility and quality of life. Bisphosphonates can reduce bone pain and augment palliative radiotherapy, although relief is often for a relatively short period of time. Ibandronate is the first bisphosphonate to provide sustained bone pain relief over 2 years and, unlike other bisphosphonates, has shown improvements in quality of life. In phase III studies of patients with bone disease from breast cancer, intravenous ibandronate 6 mg and oral ibandronate 50 mg reduced bone pain below baseline levels within 6 weeks. Significant reductions were maintained throughout the 96-week study phase compared with placebo ( P < or =.001). Two open, nonrandomized studies examined the effect of intensive, high-dose intravenous ibandronate (4 mg on 4 consecutive days, or 6 mg on 3 consecutive days) in patients with breast cancer or other tumor types with opioid-resistant bone pain and in patients with urologic cancer. In each study, ibandronate rapidly relieved moderate-to-severe metastatic bone pain, improving quality of life and patient functioning. Both intravenous and oral ibandronate provide effective long-term relief from metastatic bone pain. This clinical benefit may reduce the burden of metastatic bone disease on health care resources by limiting the need for analgesics and radiotherapy to the bone.