Bisphosphonate drugs can be used as an adjuvant therapy to improve the outcomes of women with breast cancer. Whilst many meta-analyses have quantified their potential benefits for patients, attempts at comprehensive quantification of their potential adverse effects have been much more limited. We undertook a meta-analysis with novel methodology to identify and quantify these adverse effects.
We systematically reviewed randomised controlled trials in breast cancer where at least one of the adjuvant treatments trialled was a bisphosphonate (zoledronic acid, ibandronate, pamidronate, alendronate or clodronate). Both adjuvant and neoadjuvant use were included. Primary outcomes were adverse events of any type or severity (excluding death). We carried out network meta-analysis of the trials identified in the review to estimate the size of any adverse effects potentially related to bisphosphonates.
We identified 56 trials that reported adverse data which included a total of 29,248 patients (18,301 receiving bisphosphonate drugs versus 10,947 not). 103 different adverse outcomes were analysed.
Here we give the raw data and the full list of trials found with reasons for their inclusion/exclusion in this review.
For the full network meta-analysis results please see https://chjackson.github.io/adverse/vignettes/bisph_app2_index.html