Cost-effectiveness of zoledronic acid (ZOL) for the treatment of bone loss in postmenopausal women with early-stage breast cancer receiving aromatase inhibitors in the United States (US).

2010 ◽  
Vol 28 (15_suppl) ◽  
pp. e11007-e11007
Author(s):  
S. J. Thurston ◽  
S. C. Zelt ◽  
M. Botteman
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Cost Effectiveness ◽  
Zoledronic Acid ◽  
Bone Loss ◽  
Postmenopausal Women ◽  
Aromatase Inhibitors ◽  
Early Stage ◽  
The United States ◽  
Early Stage Breast Cancer

Zoledronic Acid Inhibits Adjuvant Letrozole–Induced Bone Loss in Postmenopausal Women With Early Breast Cancer

2007 ◽  
Vol 25 (7) ◽  
pp. 829-836 ◽  
Author(s):  
Adam Brufsky ◽  
W. Graydon Harker ◽  
J. Thaddeus Beck ◽  
Robert Carroll ◽  
Elizabeth Tan-Chiu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Zoledronic Acid ◽  
Bone Loss ◽  
Postmenopausal Women ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Mineral Density ◽  
Acid Therapy ◽  
End Point ◽  
Delayed Group

Purpose Treatment with aromatase inhibitors decreases bone mineral density (BMD) and may increase the risk of fractures in postmenopausal women with early-stage breast cancer. The addition of zoledronic acid to adjuvant letrozole therapy may protect against bone loss. Patients and Methods Patients receiving adjuvant letrozole were randomly assigned to receive either upfront or delayed-start zoledronic acid (4 mg intravenously every 6 months). The delayed group received zoledronic acid when lumbar spine (LS) or total hip (TH) T score decreased to less than −2.0 or when a nontraumatic fracture occurred. The primary end point of this study was to compare the change in LS BMD at month 12 between the groups. Secondary end points included change in TH BMD and changes in serum bone turnover markers at month 12. Results The upfront and delayed groups each included 301 patients. At month 12, LS BMD was 4.4% higher in the upfront group than in the delayed group (95% CI, 3.7% to 5.0%; P < .0001), and TH BMD was 3.3% higher (95% CI, 2.8% to 3.8%; P < .0001). In the upfront group, mean serum N-telopeptide and bone-specific alkaline phosphatase concentrations decreased by 15.1% (P < .0001) and 8.8% (P = .0006), respectively, at month 12, whereas concentrations increased significantly in the delayed group by 19.9% (P = .013) and 24.3% (P < .0001), respectively. Conclusion With 1 year of follow-up, results of the primary end point of the Zometa-Femara Adjuvant Synergy Trial (Z-FAST) indicate that upfront zoledronic acid therapy prevents bone loss in the LS in postmenopausal women receiving adjuvant letrozole for early-stage breast cancer.

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