Both biophosphonates and denosumab improve bone mineral density (BMD) in men with nonmetastatic prostate cancer who are receiving androgen deprivation therapy (ADT). The results from a systematic review and meta-analysis are published in Annals of Internal Medicine.
One in two men with prostate cancer receives ADT at some point after diagnosis. While ADT has been the mainstay of treatment for decades, it is associated with many potential adverse effects, including significant bone loss and increased risk of fractures. Gaps in quality bone health care for men with prostate cancer and low rates of education about the adverse effects of ADT have led experts to call for a more systematic approach to the prevention of bone loss and fracture risk among men with this disease.
Researchers from McMaster University reviewed 30 studies evaluating the effectiveness of bone-targeted therapies aimed at preventing fracture and improving bone mineral density in men with nonmetastatic prostate cancer receiving ADT. Overall, evidence showed improvements in BMD with biophosphonates, but whether this is associated with reduced fractures remains unclear. Evidence from available trials showed fracture reduction was restricted to one drug: denosumab. Further trials studying fracture outcomes among this population are needed, researchers say.
Article: Bone Health and Bone-Targeted Therapies for Nonmetastatic Prostate Cancer: A Systematic Review and Meta-analysis, Shabbir M.H. Alibhai, MD, MSc; Katherine Zukotynski, MD; Cindy Walker-Dilks, MLS; Urban Emmenegger, MD; Antonio Finelli, MD, MSc; Scott C. Morgan, MD, MSc; Sebastién J. Hotte, MD, MSc; George A. Tomlinson, PhD; Eric Winquist, MD, MSc, Annals of Internal Medicine, published 8 August 2017.
Editorial: Maintaining Bone Health During Hormonal Therapy for Prostate Cancer, Azeez Farooki, MD; Howard I. Scher, MD, Annals of Internal Medicine, published 8 August 2017.