Document Detail


The use of zoledronic acid in men receiving androgen deprivation therapy for prostate cancer with severe osteopenia or osteoporosis.
MedLine Citation:
PMID:  20303574     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To study the effect of zoledronic acid on patients with pre-existing osteoporosis on androgen deprivation therapy (ADT), who are at highest risk for fracture. Zoledronic acid is a potent bisphosphonate that can prevent osteoporosis in patients with nonmetastatic (M0), prostate cancer (CaP) who are initiating ADT. The effect of zoledronic acid on patients with pre-existing osteoporosis on ADT, who are highest risk for fracture, has not been adequately studied. METHODS: We enrolled 28 patients with M0 CaP on ADT with severe osteopenia or osteoporosis (baseline bone-mineral density (BMD) T score < -2.0) in this open-label, single-arm trial to assess the effect of zoledronic acid on BMD. All patients also received supplemental calcium and vitamin D, and were counseled about lifestyle modifications. Patients received zoledronic acid (4 mg) intravenously every 3 months for 4 treatments. BMD was measured by dual energy X-ray absorptiometry scan at enrollment, 6 and 12 months. Primary endpoint was percent change in lumbar spine BMD. RESULTS: This was a high-risk patient population-primarily older Caucasians (mean age, 73 years), former smokers, and moderate users of alcohol. Mean duration of ADT was 2.4 years. Pre-existing osteopenia or osteoporosis was observed in a single site in 9 patients and multiple sites in 19 (68%). After 12 months of zoledronic acid, lumbar spine BMD increased 4.17% (P < .0001), and BMD increased significantly (P < .05) in both hips and the right femoral neck. Seven patients (25%) experienced improved BMD into the nonosteoporotic range (T score > -2.0). Zoledronic acid infusion was well tolerated and without substantial renal toxicity. CONCLUSIONS: Zoledronic acid improves BMD in men with M0 CaP on ADT with severe osteopenia or osteoporosis (T scores < 2.0). This novel finding identifies a high-risk patient population that can potentially benefit from bisphosphonate therapy.
Authors:
Steven C Campbell; Nirmala Bhoopalam; Thomas E Moritz; Mona Pandya; Padmini Iyer; Peter Vanveldhuizen; Nancy K Ellis; Lizy Thottapurathu; Harinder Garewal; Stuart R Warren; Nicholas Friedman; Domenic J Reda
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-03-19
Journal Detail:
Title:  Urology     Volume:  75     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-10     Completed Date:  2010-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1138-43     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Edward Hines Jr VA Hospital, Hines, Illinois, USA. campbes3@ccf.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Androgen Antagonists / therapeutic use
Bone Density Conservation Agents / therapeutic use*
Bone Diseases, Metabolic / etiology,  prevention & control*
Diphosphonates / therapeutic use*
Gonadotropin-Releasing Hormone / analogs & derivatives
Humans
Imidazoles / therapeutic use*
Male
Orchiectomy
Osteoporosis / etiology,  prevention & control*
Prostatic Neoplasms / therapy*
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Androgen Antagonists; 0/Bone Density Conservation Agents; 0/Diphosphonates; 0/Imidazoles; 118072-93-8/zoledronic acid; 33515-09-2/Gonadotropin-Releasing Hormone
Comments/Corrections
Comment In:
Urology. 2010 May;75(5):1143   [PMID:  20451736 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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