Ibandronate: An effective treatment for metastatic bone pain

Increasing evidence suggests that ibandronate, a single-nitrogen, non-cyclic bisphosphonate, provides relief of metastatic bone pain (MBP). In phase III trials, both intravenous and oral formulations of ibandronate significantly reduced MBP below baseline for up to 2 years, with concurrent improvements in patient functioning and quality of life compared with placebo. Phase II studies in patients with severe or opioid-resistant MBP suggest that loading-dose ibandronate (intravenous ibandronate 6 mg administered daily for 3 consecutive days) can provide rapid and substantial pain relief within a few days. These findings have been confirmed in clinical pilot studies. Ibandronate is the only intravenous bisphosphonate with a renal safety profile that allows loading-dose treatment. The efficacy of ibandronate in MBP should be considered when choosing a bisphosphonate treatment for metastatic bone disease.