Volume 43 (2025) – Supplementary Issue 1 – Article 17 – Epitheorese Klinikes Farmakologias kai Farmakokinetikes

Open Access Research

Bone modifying agents: incidence and risk factors of adverse reactions in bone metastasis

Tuqa Yasoub Al-sheekh Hasan¹

, Amna AlHashar²

, Buthaina Azizi², Yaman Walid Kassab¹

, Abdul Salam Nazmi^1,*

¹Pharmacy Practice Department, College of Pharmacy, National University of Science and Technology, Muscat, Oman
²Pharmacy Department, Sultan Qaboos Comprehensive Cancer Care and Research Centre, Muscat, Oman

*Corresponding author
Abdul Salam Nazmi, Pharmacy Practice Department, National University of Science and Technology, Muscat, Oman. Tel: +968-99839523; e-mail: abdulsalam@nu.edu.om

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Published: 15 October ; https://doi.org/10.61873/GKDU9085

Abstract
Background: Bone-targeted agents such as Zoledronic Acid (ZA) and Denosumab (DE) are essential in preventing skeletal-related events in cancer patients with bone metastasis. Both drugs carry risks of adverse events (AEs), including electrolyte disorder, nephrotoxicity, and osteonecrosis of the jaw. Aim: To compare the safety profiles of ZA and DE and identify risk factors associated with AEs in cancer patients with bone metastasis. Methodology: A retrospective cohort study was conducted from August 1, 2021, to August 1, 2023, at the Cancer Care and Research Centre. Adult patients with solid tumors and confirmed bone metastasis who received either ZA or DE were included. Patients taking these agents for other indications were excluded. Data from electronic health records, lab results, and medication charts were analyzed. Univariate analysis was used to assess AE risk factors. Results: A total of 250 patients were included (ZA=125, DE=125). The incidence of AEs was higher in the ZA group. Calcium disorder occurred in both groups. Comorbidities were significantly associated with increased AE risk (p<0.001). DE showed a better safety profile. Conclusion: Denosumab was linked to fewer AEs than Zoledronic Acid. Comorbidities increased AE risk, highlighting the need for preventive strategies.

Keywords: solid tumor, bone-targeted agents, calcium disorder, incidence, comorbidity

Please cite as:
Al-sheekh Hasan T. Y., AlHashar A., Azizi B., Kassab Y. W., Nazmi A. S.: Bone modifying agents: incidence and risk factors of adverse reactions in bone metastasis. Epitheorese Klin. Farmakol. Farmakokinet. 43(Sup1): 67-70 (2025). DOI: 10.61873/GKDU9085

pISSN 1011-6575 • eISSN 2945-1914