Side effects of incardronate disodium compared to pamidronate disodium in the treatment of bone metastasis pain: a systematic review and meta-analysis

Background: Bone metastasis is a common complication in patients with advanced malignant tumors and seriously impairs the quality of life of patients. Bisphosphonates are effective drugs for the treatment of bone metastasis pain. Incardronate disodium belongs to the 3rd generation of bisphosphonates. The efficacy and safety of bisphosphonates were explored using a systematic review and meta-analysis. Methods: The databases PubMed (2000 to August 2021), EMBASE (2000 to August 2021), Cochrane library (August 2021), and CNKI (China National Knowledge Infrastructure, 2000 to August 2021) were searched. Randomized controlled studies involving patients being treated with incardronate for bone metastasis pain were included in the literature search. After screening and risk of bias assessment based on the Cochrane Handbook for Systematic Reviews of Interventions, Stata 16.0 software was used for analysis. Results: The seven articles included in this study involved a total of 510 patients. Meta-analysis showed that there was no significant difference between incardronate and pamidronate disodium in the effectiveness of treating bone metastasis pain [odds ratio (OR) =1.03, 95% confidence interval (CI): 0.78-1.34, Z=0.188, P=0.851). The incidence of febrile adverse reactions from incardronate was significantly lower than pamidronate disodium (OR =0.58, 95% CI: 0.39-0.86, Z=-2.727, P=0.006). The total incidence of adverse reactions from incardronate was significantly lower than pamidronate disodium (OR=0.58, 95% CI: 0.400.85, Z=-2.851, P=0.004). Discussion: The use of incardronate in the treatment of bone metastasis pain due to malignant tumors had comparable efficacy to the second-generation bisphosphonate pamidronate disodium. However, incardronate had fewer adverse reactions than pamidronate disodium.