Prostate cancer patients on androgen deprivation therapy experience additional increases in bone mass.
PHILADELPHIA—A second year of once-weekly treatment with alendronate continues to raise bone mass at the hip and spine and prevent bone loss in the distal radius in prostate cancer patients receiving androgen deprivation therapy, data show.
The findings come from a two-year double-blind, placebo-controlled, randomized, partial crossover trial. Of 56 men with nonmetastatic prostate cancer who were randomized to receive alendronate in the first year, 51 continued into the second year.
Of the 51, 25 continued on alendronate and 26 were randomized to placebo. The primary outcome was percent change in hip and spine BMD during the second year. The patients had a mean age of about 71 years.
During the second year, the group randomized to placebo (alendronate/placebo) had statistically insignificant decreases in bone mineral density (BMD) at the spine and hip, but they had significant 1.9% decline in bone loss at the distal radius, according to lead investigator Susan Greenspan, MD. Men who received an additional year of alendronate (alendronate/alendronate) had additional significant gain in BMD during year two at the spine and hip with maintenance of bone density at the 1/3 distal radius site, Dr. Greenspan said. The differences in bone density during the second year between the two groups were significant at the hip, spine, and forearm.
“Based on our two-year findings, men should continue on bisphosphonate therapy for the greatest improvement in bone density,” said Dr. Greenspan, professor of medicine at the University of Pittsburgh. “However, patients may be able to go off alendronate and still maintain bone [density]. This therapy was well tolerated and there were no problems with adverse events in either of the two years of the study.”
Study findings were presented here at the 28th annual meeting of the American Society of Bone and Mineral Research.