Effects of Alendronate on Bone Mineral Density in Men with Prostate Cancer Treated with Androgen Deprivation Therapy

Bruder, Jan M.; Ma, J. Z.; Wing, N.; Basler, Joseph W.; Katselnik, Daniel

doi:10.1016/j.jocd.2006.07.005

Cited by 23 publications

(13 citation statements)

References 27 publications

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“…Although less well studied, BPs have also been used to prevent and treat bone loss in men with prostate cancer receiving ADT. Pamidronate (60 mg every 3 months) significantly prevented ADT‐associated BMD loss versus placebo during a small 1‐year trial ( n = 47), 68 and oral alendronate (70 mg once weekly) has demonstrated similar efficacy in two separate trials in men receiving ADT for nonmetastatic prostate cancer ( n = 47 and 112) 69,70 . In four randomized controlled trials in men with nonmetastatic prostate cancer receiving ADT ( n = 106, 120, 200, and 215, respectively), zoledronic acid (4 mg IV every 3 months for 1 year) consistently prevented BMD loss at the lumbar spine and total hip, and was significantly superior to placebo ( P ≤ 0.001 for all) 71–74 .…”

Section: Effects Of Cancer Treatments On Skeletal Healthmentioning

confidence: 99%

The use of bisphosphonates in cancer treatment

Coleman

2010

Annals of the New York Academy of Sciences

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Bone metastases result in considerable morbidity and exert complex demands on health care resources. Additionally, for many patients, metastatic bone disease is a chronic condition affecting quality of life and independence over years rather than months. The bisphosphonates, notably zoledronic acid, have been shown to reduce skeletal morbidity in multiple myeloma, as well as a wide range of solid tumors affecting bone, by 30-50%. Quite appropriately, the bisphosphonates are increasingly used alongside anticancer treatments to prevent skeletal complications and relieve bone pain. In addition, they are increasingly used to prevent cancer treatment-induced bone loss and show promise in the adjuvant setting to prevent metastasis from breast cancer.

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Section: Effects Of Cancer Treatments On Skeletal Healthmentioning

confidence: 99%

The use of bisphosphonates in cancer treatment

Coleman

2010

Annals of the New York Academy of Sciences

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“…At a median follow-up of 4 years, zoledronic acid had produced a 36% improvement in disease-free survival (DFS) (hazard ratio ¼ 0.64; P ¼ 0.01). Zoledronic acid did also show a trend towards reduced risk of death (hazard ratio ¼ 0.60; P ¼ 0.11) [39]. In addition, zoledronic acid not only decreased the frequency of bone metastases but also distant metastasis to other sites, as well as loco-regional and contralateral relapses.…”

Section: Prevention Of Bone Metastasesmentioning

confidence: 87%

“…Although less well studied, bisphosphonates have also been used to prevent and treat bone loss in men with prostate cancer receiving ADT. Pamidronate (60 mg every 3 months) significantly prevented ADT-associated BMD loss compared with placebo during a small 1-year trial (n ¼ 47) [38], and oral alendronate (70 mg once weekly) has demonstrated similar efficacy in two separate trials in men receiving ADT for nonmetastatic prostate cancer (n ¼ 47 and n ¼ 112) [39,40]. In four randomized controlled trials in men with nonmetastatic prostate cancer receiving ADT (n ¼ 106, 120, 200 and 215, Use of bisphosphonates in cancer patients Coleman and Gnant 215 respectively), zoledronic acid (4 mg intravenously every 3 months for 1 year) consistently prevented BMD loss at the lumbar spine and total hip, and was significantly superior to placebo (P 0.001 for all) [41][42][43][44].…”

Section: Men Receiving Androgen Deprivation Therapymentioning

confidence: 98%

New results from the use of bisphosphonates in cancer patients

Coleman

Gnant²

2009

Current Opinion in Supportive &Amp; Palliative Care

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“…Bruder et al. [16] retrospectively assessed 47 patients with prostate cancer treated with ADT, 22 of whom also received once‐weekly 70 mg of alendronate. There was a statistically significant difference in the percentage change of BMD per year at the spine, total hip, femoral neck and trochanter in untreated patients compared to those treated with alendronate, while there were no statistically significant differences in the four measured sites at the radius (proximal, mid ultra‐distal and total radius).…”

Section: Discussionmentioning

confidence: 99%

Alendronate decreases the fracture risk in patients with prostate cancer on androgen‐deprivation therapy and with severe osteopenia or osteoporosis

et al. 2009

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neck and total hip by dual-energy X-ray absorptiometry. All patients had severe osteopenia or osteoporosis at baseline. The risk of femoral neck fracture was calculated at baseline and 12 months (Z-score 2.7). RESULTSPatients treated with alendronate had a significant increase in BMD at the lumbar spine and femoral neck after 1 year of follow-up, with mean ( SD ) values of 1.06 (0.26) vs 1.01 (0.21) g/cm 2 at baseline ( P < 0.001), and 0.75 (0.07) vs 0.73 (0.07) g/ cm 2 ( P = 0.03), respectively, while the control group had a significant loss of BMD at the total hip of 0.79 (0.14) vs 0.81 (0.13) g/cm 2 ( P = 0.03). BMD was significantly improved at the three locations in patients treated with alendronate compared with the control group, with differences at the lumbar spine, femoral neck and total hip of 0.05 (0.07) vs 0.01 (0.10) ( P = 0.001), 0.01 (0.04) vs − 0.002 (0.03) ( P = 0.04) and 0.01 (0.04) vs − 0.01 (0.02) g/cm 2 , respectively ( P = 0.001). Patients treated with alendronate had a significant decrease in the fracture risk at the femoral neck, by − 0.54 (1.29) ( P = 0.04) after 1 year of follow-up. CONCLUSIONSTreatment with once-weekly 70 mg alendronate significantly improved the BMD at the lumbar spine and femoral neck in patients with prostate cancer with severe osteopenia or osteoporosis and on ADT, and significantly decreased the risk of femoral neck fracture. KEYWORDSprostate cancer, androgen-deprivation therapy, bisphosphonates, osteoporosis Study Type -Therapy (case control) Level of Evidence 3b OBJECTIVETo evaluate changes in bone mass and fracture risk in patients with prostate cancer on androgen-deprivation therapy (ADT) and with a basal T-score of >− 2.0, who were treated with an oral bisphosphonate, as such patients treated with ADT are at increased risk of bone loss and bone fracture. PATIENTS AND METHODSWe selected 61 patients with prostate cancer treated with ADT; 31 were treated with oral alendronate 70 mg once-weekly and a control group of 30 were not. At baseline and 12 months we measured bone mineral density (BMD) of the lumbar spine, femoral

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Effects of Alendronate on Bone Mineral Density in Men with Prostate Cancer Treated with Androgen Deprivation Therapy

Cited by 23 publications

References 27 publications

The use of bisphosphonates in cancer treatment

The use of bisphosphonates in cancer treatment

New results from the use of bisphosphonates in cancer patients

Alendronate decreases the fracture risk in patients with prostate cancer on androgen‐deprivation therapy and with severe osteopenia or osteoporosis

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