Improving bone health in men with prostate cancer on ADT: Results of a randomized phase II trial.

Alibhai, Shabbir M.H.; Breunis, Henriette; Timilshina, Narhari; Hamidi, Maryam; Tomlinson, George; Manokumar, Tharsika; Samadi, Osai; Sandoval, Joanna; Durbano, Sara; Cheung, Angela M.; Warde, Padraig; Jones, Jennifer

doi:10.1200/jco.2016.34.15_suppl.10099

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“…Given the detrimental effects of fragility fractures and the evidence of a high proportion of inappropriate ADT in PCa [66], DXA scans of PCa patients should become routine medical practice, before, during and after ADT. There are two reasons for this suggestion: the underestimated recognition of osteoporosis among PCa patients is reversible with educational strategies [67]; antiosteoporotic drugs (e.g. denosumab [68][69][70], alendronate [68], zoledronat, risedronate [71], pamidronate [72]) are effective in reducing BMD loss in PCa patients.…”

Section: Intra-group Comparisonmentioning

confidence: 99%

Osteoporosis and Bone Metabolism in Treatment-naive Primary Prostate Adenocarcinoma Patients

Bojincă¹,

Popescu²,

Bălănescu³

et al. 2018

Rev. Chim.

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The objectives of the study were to evaluate bone metabolism in primary prostate cancer (PCa) patients prior to any treatment and to compare estrogens and anti-androgens in terms of bone metabolism. The study prospectively included consecutive patients with primary PCa who were proposed for radical prostatectomy and androgen deprivation therapy (ADT; either estrogens-group E, or anti-androgens -group A) and age-matched controls. Bone markers (osteoprotegerin -OPG; osteocalcin; deoxypyridinoline) were measured before treatment and after 6 months. Bone mineral density (BMD) was measured by dual X-ray absorptiometry before treatment and after 12 months (osteoporosis was defined as a spine or hip T score � -2.5). Continuous variables are reported as mean � standard deviation. The study included 30 controls (aged 70 � 6 years), 15 patients treated with estrogens (aged 71 � 6 years) and 15 patients with anti-androgens (aged 72 � 5 years). At baseline, 0% of controls, 33.3% of group E (p = 0.002 versus controls) and 53.3% of group A (p = 0.0001 versus controls) had osteoporosis. In group E, compared to baseline, OPG (4.67 � 1.38 versus 5.27 � 1.89; p = 0.043) and DPD (6.85 � 3.24 versus 8.63 � 2.42; p = 0.008) increased, while spine (0.99 � 0.32 versus 0.94 � 0.31; p = 0.019) BMD decreased. In group A, compared to baseline, OPG (6.37 � 3.04 versus 5.02 � 1.12; p = 0.041), spine (1.03 � 0.15 versus 0.89 � 0.15; p = 0.0003) and hip (0.82 � 0.18 versus 0.75 � 0.17; p = 0.003) BMD decreased. Osteoporosis is prevalent among hormone-na�ve PCa patients. Estrogens are associated with an increase of serum OPG, while anti-androgens with a decrease of serum OPG. Irrespective of ADT type, BMD still decreases in primary PCa patients.

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