Zlepšení kvality života pacientů s kostními metastázami léčených klodronátem

Quality of life improvement in patients with bone metastases treated by clodronate

Background:
Bone metastases cause oncology patients a number of distressing problems. In addition to inducing risky episodes of hypercalceamia, they are the major cause of bone fractures, and contribute to the development of tumour pains in two-thirds of all patients, which greatly impacts upon their quality of life. Clodronate (BONEFOS^®) is one of a number of bisphosphonates that has been used for the treatment of hypercalceamia and osteolysis arising from malignant tumours for the past 20 years.

Methods, aims:
the aim of the study was to verify the effect of clodronate treatment (1 600 mg/day perorally) on the quality of life and the subjective perception of state of health in Czech oncology patients using responses from EQ-5D (and particularly the VSA - visual analogue scale – level). 300 patients with either metastasised breast cancer or multiple myeloma were included in the study.

Results:
Clodronate treatment lasted for 9 months and yielded a significant improvement in overall patient mobility (p < 0.02) and the ability to carry out normal daily tasks (p < 0.001); it significantly reduced pains and/or other marked difficulties (p < 0.001) and also lowered the incidence of anxiety attacks or depression (p < 0.001), when compared with the state before treatment. Clodronate treatment was not shown to improve a patient’s ability to look after themselves (p = 0.19). Clodronate treatment did, however, significantly improve how patients subjectively perceived their health status on the VAS scale, when compared with the start of treatment (p < 0.001).

Conclusion:
The study confirmed that clodronate (BONEFOS^®) treatment considerably improves the subjective perception of state of health in oncology patients and significantly boosts their quality of life.

Key words:
bone metastases, clodronate, quality of life.