In a nutshell
This study evaluated the use of alendronate (Fosamax) for the prevention of bone loss in men undergoing androgen deprivation therapy (ADT) for localized prostate cancer.
Some background
Androgens are a group of hormones (including testosterone) which can stimulate the growth and spread of prostate cancer cells. Androgen deprivation therapy (ADT) is considered the standard of care in the treatment of prostate cancer. ADT inhibits cancer growth by reducing the amount of testosterone produced in the body, or by blocking the effects of testosterone on cancer cells. However, ADT can cause serious side effects, including osteoporosis (loss of bone density and strength that might lead to fractures) and loss of muscle mass. Bone strength is measured as bone mineral density (BMD), which assesses the mineral content of the bones, and is strongly related to the risk of fractures.
Methods & findings
This study included 186 men diagnosed with localized prostate cancer. All participants of this study were prescribed ADT as cancer treatment. In addition to ADT, 84 (45%) of the patients received weekly doses of alendronate for one year, and 102 (55%) of the patients received a placebo (a substance without any medicinal effect used as a control). All patients were also prescribed daily calcium and vitamin D supplements. BMD was evaluated by X-ray scans at the begging of ADT and at the end of treatment one year later.
Patients receiving alendronate showed significantly increased BMD compared to patients receiving a placebo. Patients in the alendronate group showed an increase of 1.7% in BMD (as measured at the bones of the spine), while patients in the placebo group showed a 1.9% decrease in BMD.
Bone-speci?c alkaline phosphatase (BSAP), a measurement of bone degradation, was also measured. A 2.25% decrease in BSAP was seen in the alendronate treatment group, while a 3.12% increase in BSAP was seen in patients receiving a placebo.
There was no difference in the rate of reported adverse effects between the two trial groups.
The bottom line
This trial concluded that the administration of weekly alendronate significantly decreases bone loss and increases BMD in men currently undergoing ADT.
What’s next?
Consult with your physician regarding the risks of ADT and how to prevent unwanted side effects such as bone loss.
Published By :
European Urology
Date :
May 01, 2013
