Osteoporosis during Continuous Androgen Deprivation: Influence of the Modality and Length of Treatment

Moróte, Juan; Martínez, E.; Trilla, E.; Esquena, S.; Junquera, J.M. Abascal; Encabo, Gloria; Reventós, Jaume

doi:10.1016/s0302-2838(03)00379-8

Cited by 61 publications

(40 citation statements)

References 18 publications

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“…For example, in a recent long-term clinical trial of anastrozole and tamoxifen (Nolvadex ® ; AstraZeneca; Wayne, PA) in postmenopausal women with early-stage breast cancer, 7.1% of the patients treated with anastrozole and 4.4% of those treated with tamoxifen experienced fractures over 5 years. Similarly, a cross-sectional study of patients receiving long-term ADT for prostate cancer revealed that the overall relative risk of hip fracture was 20% higher in patients on ADT for 1-3 years and was 95% higher in patients on ADT for 5 years compared with rates in patients who had received radical prostatectomy but no ADT [35].…”

Section: Prevention Of Ctiblmentioning

confidence: 97%

Toward New Horizons: The Future of Bisphosphonate Therapy

Lipton

2004

The Oncologist

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Section: Prevention Of Ctiblmentioning

confidence: 97%

Toward New Horizons: The Future of Bisphosphonate Therapy

Lipton

2004

The Oncologist

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“…Instead of a short life expectancy due to an advanced tumor stage, more and more patients will undergo long-term androgen ablation with consecutive risks including osteoporosis and, in particular, pathologic fractures. This risk starts increasing after approximately 1 year of therapy and reaches a peak incidence of more than 50% after 8-10 years of testosterone withdrawal [3,4,5]. …”

Section: Discussionmentioning

confidence: 99%

“…While skeletal-related events (SREs) were almost exclusively cancer-related in the past, today many SREs are caused by osteoporosis either already prevalent at the initiation of therapy or induced by long-term hormonal treatment in a time-dependent manner [3,4,5,6]. …”

Section: Introductionmentioning

confidence: 99%

Skeletal-Related Events in Metastatic Prostate Cancer and the Number Needed to Treat: A Critical Consideration

et al. 2013

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Purpose: With stage migration induced by early diagnosis of prostate-specific antigen, the course of disease for prostate cancer (PCa) patients has changed. Increasingly, patients undergo long-term androgen ablation with consecutive risks including osteoporosis and pathologic fractures. A recent randomized trial found that the RANK ligand inhibitor denosumab was more effective preventing skeletal-related events in patients with metastatic PCa as compared to treatment with the bisphosphonate zoledronic acid. This improved efficacy was linked to an increase of side effects. Methods: The present analysis compares results reported for both substances using a number needed to treat analysis approach. Based upon these findings, risk-benefit calculations were performed. Results: The results demonstrate that for patients with bone metastatic castration-resistant PCa, decision for or against treatment with either denosumab or zoledronic acid must not only consider efficacy but needs to balance the desired effects versus potential side effects. This is of specific relevance since life expectancy is limited in this patient cohort with end-stage disease. Conclusions: Further scientific efforts are necessary to identify optimal dosing and application intervals for denosumab and zoledronic acid as well as to answer the question of optimal duration of treatment. These findings will directly impact the risk versus benefit relations for both therapeutic options.

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“…[10][11][12] Bisphosphonates have already been used for treatment of primary osteoporosis and were also reported to prevent bone loss caused by ADT. 13 Smith et al 14 reported that patients undergoing ADT who received 60 mg of pamidronate intravenously every 12 weeks exhibited no significant changes from baseline BMD at the lumbar spine, total hip and trochanter, in Mean % changes in BMD/YAM ratio.…”

Section: Discussionmentioning

confidence: 99%

Risedronate prevents persistent bone loss in prostate cancer patients treated with androgen deprivation therapy: results of a 2-year follow-up study

Izumi

Mizokami

Sugimoto

et al. 2011

Prostate Cancer Prostatic Dis

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Androgen deprivation therapy (ADT) for prostate cancer (PCa) causes bone loss. Although we reported previously that risedronate significantly recovers bone mineral density (BMD) for up to 12 months, there have been no reports with longer follow-up periods to date. This study extended our earlier series extending the follow-up period to 24 months. Eligible patients had histologically confirmed PCa without lumbar spine metastasis and underwent ADT. Lumbar spine BMD, urinary deoxypyridinoline (uDPD) and serum bone alkaline phosphatase were measured at 6, 12 and 24 months. Among the total of 96 patients, we analyzed 26 and 18 patients in risedronate administration and control groups, respectively. BMD relative to the young adult mean ratio, uDPD and serum bone alkaline phosphatase of the risedronate administration group recovered significantly after 24 months compared with the control group (Po0.0001, P ¼ 0.0001, and Po0.0001, respectively). Transient blurred vision, malaise and vertigo were observed in 1 patient each among the 46 patients treated with risedronate within 28 days after first administration. Oral administration of risedronate is safe and effective for the recovery of ADT-induced bone loss in PCa patients even at 24 months after commencement of treatment.

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Osteoporosis during Continuous Androgen Deprivation: Influence of the Modality and Length of Treatment

Cited by 61 publications

References 18 publications

Toward New Horizons: The Future of Bisphosphonate Therapy

Toward New Horizons: The Future of Bisphosphonate Therapy

Skeletal-Related Events in Metastatic Prostate Cancer and the Number Needed to Treat: A Critical Consideration

Risedronate prevents persistent bone loss in prostate cancer patients treated with androgen deprivation therapy: results of a 2-year follow-up study

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