Efficacy, safety and economy of denosumab and zoledronic acid in the treatment of bone metastases of solid tumors and multiple myeloma: a systematic review and meta-analysis.

( 22 )] shifted the P-value to borderline significance (P > 0.05), although the direction of the effect consistently favored denosumab (OR < 1.0). 3.6 Assessment outcomes of the GRADE evidence grading system The certainty of evidence for each outcome was systematically assessed using the GRADE framework, which evaluates five domains: risk of bias, inconsistency, indirectness, imprecision, and publication bias.

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Although the test for subgroup differences did not reach statistical significance (P = 0.15), this finding suggests a potential specific benefit in the myeloma population that contrasts with the results in solid tumors. 3.4.5 Overall safety outcomes: any adverse events and serious adverse events The general safety profile of denosumab versus zoledronic acid is summarized in Figure 7 .

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