Prolonged Prostate Cancer Hormone Therapy Raises Fracture Risk

ADT for more than 1 year is associated with a 2.5 times higher odds of fracture in prostate cancer patients.
ADT for more than 1 year is associated with a 2.5 times higher odds of fracture in prostate cancer patients.

Prolonged use of androgen-deprivation therapy (ADT) is associated with substantial risk of fracture in prostate cancer (PCa) patients, but short-term use is not, investigators reported.

Writing in Prostate Cancer and Prostatic Disease (2014;17:338-342), Alicia K. Morgans, MD, of Vanderbilt University School of Medicine in Nashville, Tenn., and colleagues concluded that these findings “should be considered when weighing the advantages and disadvantages of ADT in men with prostate cancer.”

Dr. Morgans' group studied 961 PCa survivors with non-metastatic disease at the time of diagnosis and who completed 15-year follow-up surveys. Of the 961 men, 157 (16.3%) received prolonged ADT (more than 1 year), 120 (12.5%) received short-term ADT (1 year or less), and 684 (71.2%) did not received ADT.

Men who received prolonged ADT had a significant 2.5 times higher odds of fracture than men who did not received ADT. Additionally, they had a significant 5.9 times higher odds of undergoing bone mineral testing and 4.3 times higher odds of bone medication use. Men who received short-term ADT reported rates of fracture similar to men not treated with ADT, according to the investigators.

“Continued efforts to reduce skeletal complications for men receiving ADT should focus on reducing overtreatment of men with ADT when possible, and addressing skeletal health screening and complication prevention in men receiving prolonged ADT,” the authors concluded.

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