Overnight fasting serum cholesterol, HDL, LDL and triglycerides levels and bone mineral density (BMD) values during adjuvant letrozole in daily practice.

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 11040-11040
Author(s):  
C. Fontaine ◽  
M. Huizing ◽  
A. Dewaele ◽  
K. Vandenbossche ◽  
J. Vermey ◽  
...  

11040 Background: Background: Randomized clinical trials (RCT’s) have demonstrated a superiority of adjuvant aromatase inhibitors (AI’s) over tamoxifen (TAM) in disease free survival and overall survival, immediately postoperatively, in cross-over or extended setting in hormone receptor positive BC. In these studies AI’s were associated with increased bone demineralization and a rise in non- fasting serum cholesterol. Patients and methods: The tolerance for adjuvant letrozole was reviewed in 185 postmenopausal women with hormone receptor-positive early BC including fasting cholesterol levels and bone mineral density (BMD) values. Results: 121 patients (pts) received first-line adjuvant letrozole and 64 pts were crossed over from TAM. Median follow-up was 26 months (15–63 mths). Median age was 56 yrs (37–85y). Median time on letrozole was 23 months. Forty three of the 185 (24 %) of the pts discontinued the adjuvant therapy with letrozole (after a median duration of treatment of 5 months (1wk-30mths)), because of intolerance (83.7%)and PD in 16.3%. Median overnight fasting serum cholesterol levels did not change significantly (p=0.4) over a 2 year observation period from (203.5 mg/dl (131–342)) baseline to (205.5 mg/dl (151–330)) follow-up in 32 evaluable (14/32 pts prior TAM) pts. Median HDL levels rose from 65.5 mg/dl (38–107) to 70 mg/dl (38–103) (p=0.03) after 2 years, but LDL levels did not rise significantly. In the contrary triglycerides levels decreased from 122.5 mg/dl (48–238) to 105 mg/dl (47–285) (p=0.01). Despite the use of upfront biphosphonates in 1/3 of the pts, loss of BMD was significant for the lumbar spine after 2 years in 22 evaluable (8/22 prior TAM) pts (median T-score decreased from minus 0.3 to -0. 45, p=0.02), but not for the hip. Conclusion: Adjuvant letrozole did not significantly increase overnight fasting serum cholesterol levels in daily practice. Adjuvant letrozole was associated with a significant rise in HDL levels and a significant decrease in triglycerides levels after 2 years of therapy. Loss of BMD was observed in concordance with results from RCT’s. Adjuvant letrozole had to be discontinued prematurely because of tolerance issues in 20 % of the pts. No significant financial relationships to disclose.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 552-552
Author(s):  
Katsuhiko Nakatsukasa ◽  
Takayuki Matsuda ◽  
Tetsuya Taguchi

552 Background: Adjuvant aromatase inhibitor (AI) therapy is well established in postmenopausal women with hormone receptor-positive breast cancer, but such therapy is associated with bone loss and increased fracture risk. Denosumab, a fully human monoclonal antibody against receptor of nuclear-κB ligand, was previously proven to protect against AI-induced bone loss. In Japan, however, the efficacy of denosumab in the treatment of AI-associated bone loss has not been proven in a prospective study. Methods: This non-randomized prospective study was conducted at four institutions in Japan. we prospectively evaluated the bone mineral density (BMD) of the lumbar spine and bilateral femoral neck in hormone-receptor positive clinical stageⅠ–ⅢA, postoperative postmenopausal breast cancer patients who were scheduled for treatment with AI as adjuvant endocrine therapy or during AI adjuvant therapy. They received supplemental calcium, vitamin D and subcutaneous denosumab 60mg (n=103) every six months. At enrollment, all patients were required to have evidence of low bone mass, excluding osteoporosis. The primary endpoint was percentage change in lumbar spine BMD from baseline to month 12. The secondary endpoint was percentage change in bilateral femoral neck BMD from baseline to month 12. This is the first trial where the right and left femoral neck BMD are measured separately. Results: We enrolled 103 patients between November, 2014 to October, 2016. At 12 months, lumber spine BMD increased by 4.7 %. The patients who were administered prior AI therapy (n=60) had a 4.8 % increase, and the patients without prior AI therapy (n=40) had a 4.6 % increase. At 12 months, the right and left femoral neck BMD increased by 2.9 % and 2.0 %, respectively. Hypocalcemia ≥ grade2, osteonecrosis of the jaw (ONJ) and non-traumatic clinical fracture were absent in this study. Conclusions: Twice-yearly treatment with denosumab was associated with consistently greater gains in BMD among Japanese women receiving adjuvant AI therapy, regardless of whether prior AI therapy was administered. Clinical trial information: UMIN000013863.


2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22187-e22187
Author(s):  
H. J. Kim ◽  
E. Park ◽  
W. Lim ◽  
J. Sei ◽  
B. Koh ◽  
...  

e22187 Background: Bone mass has been proposed as a marker of cumulative exposure to estrogen in women. We have studied the association between bone mass and breast cancer in postmenopausal women. Methods: We investigated the association between bone mineral density(BMD), as measured at the lumbar spine and femoral neck and the breast cancer in women age 50 or older, who were received an initial diagnosis of stage 0-III breast cancer, confirmed by pathologic assessment of breast tissue. We recruited 718 women with newly diagnosed breast cancer in a Asan Medical Center from 1, Jun. 2006 to 31, Dec. 2007. BMD was measured by lunar EXPERT-XL for breast cancer patients Results: Median age at diagnosis was 58 (range 47–82). Patients with higher BMD at lumbar spine were found to have low grade disease (p<0.005). The patients with hormone receptor positive breast tumor showed higher BMD at lumbar spine and lower serum 25(OH)D than hormone receptor negative tumor. Serum estradiol level did not show a relation to BMD. There were no significant differences between breast cancer stage and serum 25(OH)D and BMD. Conclusions: The patients who have hormone receptor positive breast cancer had higher Lumbar spine BMD and lower 25(OH)D than hormone receptor negative patients. No significant financial relationships to disclose.


2014 ◽  
Author(s):  
Mingo Dominguez Maria Luisa de ◽  
Sonsoles Guadalix Iglesias ◽  
Maria Begona Lopez Alvarez ◽  
Guillermo Martinez Diaz-Guerra ◽  
Federico Hawkins Carranza

Author(s):  
Gabriella Martino ◽  
Federica Bellone ◽  
Carmelo M. Vicario ◽  
Agostino Gaudio ◽  
Andrea Caputo ◽  
...  

Clinical psychological factors may predict medical diseases. Anxiety level has been associated with osteoporosis, but its role on bone mineral density (BMD) change is still unknown. This study aimed to investigate the association between anxiety levels and both adherence and treatment response to oral bisphosphonates (BPs) in postmenopausal osteoporosis. BMD and anxiety levels were evaluated trough dual-energy X-ray absorptiometry and the Hamilton Anxiety Rating Scale (HAM-A), respectively. Participants received weekly medication with alendronate or risedronate and were grouped according to the HAM-A scores into tertiles (HAM-A 3 > HAM-A 2 > HAM-A 1). After 24 months, BMD changes were different among the HAM-A tertiles. The median lumbar BMD change was significantly greater in both the HAM-A 2 and HAM-A 3 in comparison with the HAM-A 1. The same trend was observed for femoral BMD change. Adherence to BPs was >75% in 68% of patients in the HAM-A 1, 79% of patients in the HAM-A 2, and 89% of patients in the HAM-A 3 (p = 0.0014). After correcting for age, body mass index, depressive symptoms, and the 10-yr. probability of osteoporotic fractures, anxiety levels independently predicted lumbar BMD change (β = 0.3417, SE 0.145, p = 0.02). In conclusion, women with higher anxiety levels reported greater BMD improvement, highlighting that anxiety was associated with adherence and response to osteoporosis medical treatment, although further research on this topic is needed.


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