Both bisphosphonates and denosumab (marketed by Amgen as Prolia® and Xgeva®) improve bone mineral density (BMD) in men with nonmetastatic prostate cancer who are receiving androgen deprivation therapy or 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.
A multi-disciplinary panel 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 bisphosphonates, 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 noted.
Last editorial review: August 7, 2017
Featured Image: Prostate Cancer Courtesy: © 2017. Fotolia. Used with permission.
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