Review: bisphosphonates are modestly better than placebo for relieving painful bone metastases.

M e t h o d s Data sources: 7 databases, scientific proceedings, and abstracts of professional associations. Study selection and assessment: Randomized controlled trials (RCTs) that included patients who had bone metastases with or without pain at enrollment, measured pain as an outcome, allowed antineoplastic therapy or rescue pain medications (if available to all patients), and compared bisphosphonates with a control intervention (placebo, no treatment, different types of bisphosphonates, different doses of the same bisphosphonate, or other treatments). Study quality was assessed using the 5-point Jadad scale. Outcomes: Pain relief. Secondary outcomes included dose response of bisphosphonates for reducing pain, quality of life (QOL), and adverse effects (AEs).