Table 3.
Adverse Events of Bisphosphonates in Glucocorticoid-Treated Patients With DMD
| Adverse event category | ||||||||
| Author [country] | Interventions | Dizziness/vomiting | Fever | Fatigue | Headache | Gastrointestinala | Muscle/bone pain | Other |
| Case et al. [UK]10 | DFZ/PRED + ZLN | 1 (100%) | 1 (100%) | 0 (0%) | 0 (0%) | 1 (100%) | 0 (0%) | • Chest pain: 1 (100%) • Tachycardia: 1 (100%) • Tachypnea: 1 (100%) • Hypoglycemia: 1 (100%) • Hypocalcemia: 1 (100%) • Hypophosphatemia: 1 (100%) • Hyponatremia: 1 (100%) • Hypokalemia: 1 (100%) |
| Gordon et al. [CAN]11 | DFZ/PDN + ALN/CLO/PAM | NR | NR | NR | NR | NR | NR | NR |
| Hawker et al. [CAN]12 | DFZ + ALN | 2 (13%) | 0 (0%) | 0 (0%) | 4 (25%) | 8 (50%) | 4 (25%) | • Memory loss: 1 (6%) • Rash: 1 (6%) |
| Houston et al. [USA]13 | DFZ/PDN + ALN | NR | NR | NR | NR | NR | NR | NR |
| Ivanyuk et al. [CH]14 | NR + ZLN | NR | NR | NR | NR | NR | NR | Rhabdomyolysis with myoglobinuriac |
| Joseph et al. [UK]4 | DFZ/PRED + NR | NR | NR | NR | NR | NR | NR | NR |
| Lemon et al. [UK]15 | DFZ + ZLN | NR | NR | NR | NR | NR | NR | Rhabdomyolysis with myoglobinuriac |
| Lim et al. [AUS]27 | DFZ/PRED + ZLN | 0 (0%)d | 0 (0%)d | 0 (0%)d | 0 (0%)d | 0 (0%)d | 0 (0%)d | 0 (0%)d |
| Misof et al. [CAN]16 | DFZ/PDN + PAM/ZLN | NR | NR | NR | NR | NR | NR | NR |
| Moretti et al. [IT]17 | DFZ + NER | NR | NR | NR | NR | NR | NR | NR |
| Nasomyont et al. [USA]18 | DFZ/PDN + ALN | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) |
| Palomo Atance et al. [ES]19 | DFZ + ALN | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) |
| Ronsley et al. [CAN]20 | DFZ/PDN + PAM/ZLN | NR | NR | NR | NR | NR | 22 (69%) | • Chills: 22 (69%) • Muscle cramps/spasms: 19 (59%) • Numbness/tingling: 21 (66%) |
| Sbrocchi et al. [CAN]21 | DFZ + PAM/ZLN | 0 (0%) | 4 (57%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | • Asymptomatic ionized hypocalcemia: 2 (29%) |
| Srinivasan et al. [UK]22 | DFZ/PRED + RIS | Yesc | Yesc | 0 (0%) | 0 (0%) | Yesc | Yesc | 0 (0%) |
| Tian et al. [USA]23 | NR + ALN | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) |
| Ward et al. [multinationalb]24 | NR + ZLN | 4 (22%) | 4 (22%) | 1 (6%) | 4 (22%) | 4 (22%) | 6 (33%) | • Hypocalcemia: 2 (11%) • Tachycardia: 3 (17%) • Adrenal insufficiency: 3 (17%) • Nausea: 3 (17%) |
| Zacharin et al. [AUS/NZ]25 | DFZ/PRED + ZLN | NR | NR | NR | NR | NR | NR | • Asymptomatic hypocalcemia: 10 (37%) after 48 h and 4 (16%) after 72 h • Asymptomatic hypophosphatemia: 1 (4%) after 48 h and 3 (13%) after 72 h |
| Zheng et al. [CN]26 | PRED + ALN | 0 (0%) | 0 (0%) | 0 (0%) | 1 (6%) | 5 (28%) | 1 (6%) | 0 (0%) |
| PRED + ZLN | 0 (0%) | 12 (71%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | |
Abbreviations: ALN = Alendronate; AUS = Australia; CAN = Canada; CH = Switzerland; CLO = Clodronate; CN = China; DFZ = Deflazacort; DMD = Duchenne muscular dystrophy; ES = Spain; IT = Italy; NER = Neridronate; NR = Not reported; NZ = New Zealand; PAM = Pamidronate; PDN = Prednisone; PRED = Prednisolone; RIS = Risedronate; UK = United Kingdom; USA = United States of America; ZLN = Zoledronate.
Data reported as n (proportion %) if not otherwise stated.
a
Diarrhea, constipation, nausea, heartburn, or abdominal pain.
b
Canada, Australia, the United Kingdom, South Africa, Russia, and Hungary.
c
Number of affected patients not reported.
d
Serious adverse events.