In a nutshell
This study evaluated the effectiveness of antiresorptive drugs on bone mineral density (BMD) in postmenopausal women with early-stage breast cancer (BC) receiving treatment with aromatase inhibitors (AIs). The data showed that denosumab (Prolia) and zoledronic acid (Aclasta) were the most effective antiresorptive treatment options to improve BMD in these patients.
Breast cancer (BC) is one of the most common cancers affecting women worldwide. Many of these patients have a type of tumor that grows in response to female hormones such as estrogen and progesterone. These are called hormone receptor-positive (HR+). Aromatase inhibitors (AI) which reduce the production of estrogen are used to treat this type of BC in postmenopausal women.
AIs are very effective in improving survival outcomes. However, AIs are associated with musculoskeletal symptoms (MSS) including joint pain, aching or stiffness in the body, twitching of muscles, and fatigue. They also decrease BMD causing osteoporosis and increased fracture risk. This can negatively affect patients' health-related quality of life (HRQoL).
Bisphosphonates (BPs) such as zoledronic acid or zoledronate, ibandronate (Bonviva), alendronate (Fosamax), risedronate (Actonel), and clodronate (Bonefos) are called antiresorptive drugs that slow or stop the natural process that dissolves bone tissue. This helps maintain or increase BMD. BPs are commonly used to treat osteoporosis. Additionally, BPs create an environment in the bones that does not favor the survival of cancer cells.
Denosumab is a targeted drug that blocks the action of osteoclasts (cells that degrade bone). However, there are few studies comparing the effectiveness of antiresorptive drugs on BMD in postmenopausal women with early-stage BC receiving treatment with AIs.
Methods & findings
This study analyzed 15 studies that involved postmenopausal women with early-stage BC treated with AIs. All patients received antiresorptive drugs (BPs and/or denosumab) for low BMD.
Both bisphosphonates and denosumab increased BMD in these patients. Only denosumab significantly reduced the risk of fractures in patients with early-stage BC receiving treatment with AIs.
The bottom line
This study concluded that denosumab and zoledronic acid were the most effective antiresorptive treatment options to improve BMD in postmenopausal women with early-stage BC receiving treatment with AIs.
The fine print
This study only included randomized controlled studies and did not include observational studies. The studies analyzed had different methodologies.
Published By :
Frontiers in oncology
Feb 08, 2022
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