Osteoporosis Program Helps Men on Androgen Suppression for Prostate Cancer

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WASHINGTON, D.C.—Men receiving androgen suppression for prostate cancer (PCa) and participated in an osteoporosis disease management program had a significantly decreased incidence of hip fractures compared with those not in the program, according to a study presented at the American Urological Association 2011 annual meeting.

The study was conducted by Joseph Gleason, MD, and colleagues at Kaiser Permanente Southern California (KPSC), which pioneered and implemented its Health Bones Program (HBP) at all KPSC hospitals in 2002. In the program, which is available to any patient who is at risk for developing osteoporosis, patients undergo dual x-ray absorptiometry scans and are started on oral vitamin D/calcium and/or bisphosphonate therapy based on their initial T score.

Investigators studied 1,482 patients diagnosed with PCa between January 2003 and December 2007 and had been treated with leuprolide. Of these, 1,071 were in the HBP and 411 were not and served as controls. The incidence rate of hip fractures per 1,000 person-years was lower for the HBP than the non-HBP group (5.1 vs. 18.1), investigators reported in a poster presentation. For patients who suffered hip fractures, the median time from first leuprolide dose to hip fracture was longer for the HBP than non-HBP group (823 vs. 590 days).

The HBP group was older than the non-HBP group (74 vs. 71 years). The mean total number of leuprolide dosages given was significantly higher for the HBP patients (6.3 vs. 4.8). The two groups were comparable with respect to racial composition.

Due to the high health care costs and morbidity and mortality associated with hip fractures, the investigators concluded, the findings may have significant implications for managing on androgen suppression for PCa, the researchers concluded.

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