THERAPEUTIC EFFICACY AND PHARMACOECONOMICS EVAULATION OF PAMIDRONATE VERSUS ZOLEDRONIC ACID IN MULTIPLE MYELOMA PATIENTS
Saima Qasim1, Uzma Saleem2, Bashir Ahmad1, Muhammad Tahir Aziz3, M. Imran Qadir2, Saeed Mahmood4, Khurram Shahzad1
1University College of Pharmacy, University of the Punjab, Lahore, Pakistan 2College of Pharmacy, GC University, Faisalabad, Pakistan 3Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan 4Lahore General Hospital, Lahore, Pakistan
Keywords: Sixty patients of multiple myeloma were randomized into two equal groups to receive Pamidronate and Zoledronic acid intravenously every month for a total of six months. The primary endpoint was to compare the therapeutic efficacy of both drugs by the resolution of hypercalcemia, prevention of skeletal related events and pathological fractures. The secondary endpoints were to assess patient compliance on the basis of quality of life score before and after treatment with Pamidronate and Zoledronic acid and to analyze the cost effectiveness of both drugs., Pamidronate was found to be more effective in the resolution of hypercalcemia as compared to Zoledronic acid, whereas Zoledronic acid reduced the overall proportion of skeletal related events (45.9%) in comparison with Pamidronate (54.1%). Overall Quality of life scores were not significantly influenced by either the response or the occurrence of adverse event but were statistically significant (P=0.000), with in the treatment groups. Patients on Zoledronic acid were more comfortable due to short administration time of l5minutes as compared to 2 hours of Pamidronate. The average cost of six months’ treatment with Zoledronic acid was significantly higher (PKR=90, 000 or USD 1,052) in comparison with Pamidronate (PKR=39, 000 USD 456. Zoledronic acid reduced the risk of developing skeletal complications including hypercalcemia and was significantly more effective in reducing the incidence of hypocalcemia. The incidence of renal impairment among patients treated with Zoledronic acid was significantly higher, but severity of nephrotoxicity was more with Pamidronate. The most common adverse effects were pain, vomiting and fatigue in both treatment groups. Comparatively, Pamidronate was more effective in resolution of hypercalcemia, while Zoledronic acid have better therapeutic effects in reduction of skeletal related events and pathological fractures.
Abstract

Pamidronate, Zoledronic acid, Efficacy, Pharmacoeconomics, Multiple myeloma

Article Information

Identifiers and Pagination:
Year:2011
Volume:3
First Page:438
Last Page:452
Publisher Id:JAppPharm (2011 ). 3. 438-452
Article History:
Received:June 7, 2011
Accepted:October 5, 2011
Collection year:2011
First Published:October 20, 2011


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Editor in Chief
Prof. Dr. Cornelia M. Keck (Philipps-Universität Marburg)
Marburg, Germany

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Welcome to the research group of Prof. Dr. Cornelia M. Keck in Marburg. Cornelia M. Keck is a pharmacist and obtained her PhD in 2006 from the Freie Universität (FU) in Berlin. In 2009 she was appointed as Adjunct Professor for Pharmaceutical and Nutritional Nanotechnology at the University Putra Malaysia (UPM) and in 2011 she obtained her Venia legendi (Habilitation) at the Freie Universität Berlin and was appointed as a Professor for Pharmacology and Pharmaceutics at the University of Applied Sciences Kaiserslautern. Since 2016 she is Professor of Pharmaceutics and Biopharmaceutics at the Philipps-Universität Marburg. Her field of research is the development and characterization of innovative nanocarriers for improved delivery of poorly soluble actives for healthcare and cosmetics. Prof. Keck is executive board member of the German Association of Nanotechnology (Deutscher Verband Nanotechnologie), Vize-chairman of the unit „Dermocosmetics“ at the German Society of Dermopharmacy, active member in many pharmaceutical societies and member of the BfR Committee for Cosmetics at the Federal Institute for Risk Assessment (BfR).

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Abbreviation: J App Pharm
doi: http://dx.doi.org/10.21065/19204159
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