scholarly journals Multidisciplinary Consensus on the Prevention and Treatment of Osteoporosis and Fragility Fractures in Patients with Prostate Cancer Receiving Androgen-Deprivation Therapy

2022 ◽  
Vol 40 (1) ◽  
pp. 74
Author(s):  
Enrique Casado ◽  
Angel Borque-Fernando ◽  
Manuel Caamaño ◽  
Jenaro Graña ◽  
Jesús Muñoz-Rodríguez ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Fragility Fractures ◽  
Androgen Deprivation ◽  
Treatment Of Osteoporosis ◽  
Prevention And Treatment

scholarly journals Emerging Therapies to Prevent Skeletal Morbidity in Men With Prostate Cancer

2011 ◽  
Vol 29 (27) ◽  
pp. 3705-3714 ◽  
Author(s):  
Philip J. Saylor ◽  
Richard J. Lee ◽  
Matthew R. Smith
Keyword(s):  
Prostate Cancer ◽  
Fracture Risk ◽  
Androgen Deprivation Therapy ◽  
Osteoporotic Fracture ◽  
Kinase Inhibitor ◽  
Fragility Fractures ◽  
Androgen Deprivation ◽  
Castration Resistant Prostate Cancer ◽  
Mineral Density ◽  
Radium 223

Skeletal morbidity is a prominent burden to men with advanced prostate cancer throughout the natural history of the disease. Bone metastases can cause pain and greatly elevate the risk for fractures and other structural complications. Distinct from the problem of metastases, treatment-related osteoporosis and associated fragility fractures are potential complications of androgen-deprivation therapy. Bone-targeted therapies for prostate cancer have therefore been the focus of considerable research and drug development efforts. The osteoclast is a validated therapeutic target in the management of prostate cancer. Osteoclast inhibition with zoledronic acid (a bisphosphonate) or with denosumab (a monoclonal antibody to RANK ligand) reduces risk for skeletal events in men with castration-resistant prostate cancer metastatic to bone. Osteoclast inhibition with any of several bisphosphonates improves bone mineral density, a surrogate for osteoporotic fracture risk. Denosumab and toremifene (a selective estrogen receptor modulator) have each been shown to reduce osteoporotic fracture risk among men receiving androgen-deprivation therapy. Beta-emitting radiopharmaceuticals reduce pain due to metastatic disease. Investigations involving alpha-emitting radium-223, endothelin-A receptor antagonists atrasentan and zibotentan, proto-oncogene tyrosine-protein kinase (SRC) inhibitor dasatinib, and tyrosine kinase inhibitor cabozantinib (XL184) are ongoing in clinical trials and are also discussed.

scholarly journals Impact of Androgen Deprivation Therapy on Cardiovascular Disease and Diabetes

2009 ◽  
Vol 27 (21) ◽  
pp. 3452-3458 ◽  
Author(s):  
Shabbir M.H. Alibhai ◽  
Minh Duong-Hua ◽  
Rinku Sutradhar ◽  
Neil E. Fleshner ◽  
Padraig Warde ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Sudden Cardiac Death ◽  
Androgen Deprivation Therapy ◽  
Fragility Fracture ◽  
Cardiac Death ◽  
Fragility Fractures ◽  
Androgen Deprivation ◽  
Administrative Databases ◽  
Increased Risk ◽  
Bilateral Orchiectomy

Purpose Use of androgen deprivation therapy (ADT) may be associated with an increased risk of diabetes mellitus but the risk of both acute myocardial infarction (AMI) and cardiovascular mortality remain controversial because few outcomes and conflicting findings have been reported. We sought to clarify whether ADT is associated with these outcomes in a large, representative cohort. Methods Using linked administrative databases in Ontario, Canada, men age 66 years or older with prostate cancer given continuous ADT for at least 6 months or who underwent bilateral orchiectomy (n = 19,079) were matched with men with prostate cancer who had never received ADT. Treated and untreated groups were matched 1:1 (ie, hard-matched) on age, prior cancer treatment, and year of diagnosis and propensity-matched on comorbidities, medications, cardiovascular risk factors, prior fractures, and socioeconomic variables. Primary outcomes were development of AMI, sudden cardiac death, and diabetes. Fragility fracture was also examined. Results The cohort was observed for a mean of 6.47 years. In time-to-event analyses, ADT use was associated with an increased risk of diabetes (hazard ratio [HR], 1.16; 95% CI, 1.11 to 1.21) and fragility fracture (HR, 1.65; 95% CI, 1.53 to 1.77) but not with AMI (HR, 0.91; 95% CI, 0.84 to 1.00) or sudden cardiac death (HR, 0.96; 95% CI, 0.83 to 1.10). Increasing duration of ADT was associated with an excess risk of fragility fractures and diabetes but not cardiac outcomes. Conclusion Continuous ADT use for at least 6 months in older men is associated with an increased risk of diabetes and fragility fracture but not AMI or sudden cardiac death.

scholarly journals Corrigendum to “The Current Practice of Screening, Prevention, and Treatment of Androgen-Deprivation-Therapy Induced Osteoporosis in Patients with Prostate Cancer”

2017 ◽  
Vol 2017 ◽  
pp. 1-1
Author(s):  
Humaid O. Al-Shamsi ◽  
Arthur N. Lau ◽  
Kartika Malik ◽  
Abdulaziz Alamri ◽  
George Ioannidis ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Current Practice ◽  
Androgen Deprivation ◽  
Prevention And Treatment
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