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For the remainder of the patient's life, these bone metastases lead to skeletal\u2010related events such as pathologic fractures and spinal cord compression, as well as bone pain or lesions requiring palliative radiation therapy or surgery to prevent or treat fractures. Skeletal\u2010related events result in increased morbidity, mortality and health care costs. For the past decade, intravenous bisphosphonates (zoledronic acid, pamidronate) have been recognized as the primary pharmacologic options in the prevention or treatment of skeletal\u2010related events in patients with bone metastasis. Recently, the United States Food and Drug Administration approved denosumab, a fully human monoclonal antibody, for the prevention of skeletal\u2010related events in patients with bone metastases from solid tumors. Three prominent clinical trials were conducted to establish the efficacy of denosumab. In two of three trials, denosumab was found to delay the time to first skeletal\u2010related event significantly more than zoledronic acid in patients with breast or castration\u2010resistant prostate cancer with bone metastasis. The third trial found denosumab to be noninferior to zoledronic acid in patients with metastases from solid tumors, excluding breast and prostate solid tumors. Overall survival and progression\u2010free survival were similar between zoledronic acid and denosumab. Thus, evidence is insufficient to prove a greater efficacy of one agent over the other. According to the American Society of Clinical Oncology and the National Comprehensive Cancer Network, patients with bone metastasis should have zoledronic acid, pamidronate, or denosumab (with calcium and vitamin D supplementation) added to their chemotherapy regimen if they have an expected survival of 3\u00a0months or longer and have adequate renal function.<\/jats:p>","DOI":"10.1002\/j.1875-9114.2011.01092.x","type":"journal-article","created":{"date-parts":[[2012,9,5]],"date-time":"2012-09-05T03:55:07Z","timestamp":1346817307000},"page":"274-284","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Denosumab for the Prevention of Skeletal\u2010Related Events in Patients with Bone Metastasis from Solid Tumor"],"prefix":"10.1002","volume":"32","author":[{"given":"Maryam","family":"Iranikhah","sequence":"first","affiliation":[{"name":"Samford University McWhorter School of Pharmacy Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa W.","family":"Wilborn","sequence":"additional","affiliation":[{"name":"Samford University McWhorter School of Pharmacy Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terri M.","family":"Wensel","sequence":"additional","affiliation":[{"name":"Samford University McWhorter School of Pharmacy Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jodi B.","family":"Ferrell","sequence":"additional","affiliation":[{"name":"Samford University McWhorter School of Pharmacy Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,2,13]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Cancer facts and figures 2010","author":"American Cancer Society","year":"2010"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20100625-20"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22991"},{"key":"e_1_2_10_5_1","first-page":"1","article-title":"Bones, breasts, and bisphosphonates: rationale for the use of zoledronic acid in advanced and early breast cancer","volume":"3","author":"Lipton A","year":"2011","journal-title":"Breast Cancer: Targets Therapy"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-11-29"},{"key":"e_1_2_10_7_1","unstructured":"National Comprehensive Cancer Network.NCCN clinical practice guidelines in oncology. 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