Androgen deprivation in prostate cancer and the long-term risk of fracture

To determine the rate of bone mass loss and the risk of fracture induced by androgen deprivation therapy in patients with prostate cancer.

Prospective study in 2 phases. In the first phase, demographic variables, FRAX(®), bone mineral density and clinical fractures were collected, before starting the therapy and up to 1 year after ending the therapy. In the second phase, we conducted a telephone interview a mean of 8.5 years after the start of the study to assess new fractures.

We included 150 patients with a mean age of 67 years and a mean therapy duration of 24 months. Before starting the treatment, 62 patients (41%) showed osteoporosis or low bone mass in the densitometry. After the first year of treatment, the bone mineral density decreased a mean of 3.7% and 2.1% in the lumbar spine and femoral neck, respectively. At the end of the second and third year, the loss rate was lower. During the first phase of the study, 4 patients (2.7%) experienced a fracture. In the telephone interviews with 80 patients (53%), only 1 had experienced a fracture.

In the patients with prostate cancer and androgen deprivation therapy, greater bone loss occurred during the first year. When the treatment did not exceed 2 years, the absolute risk of fracture was low, and clinical fractures were uncommon in the short and long term.

Actas urologicas espanolas. 2017 Mar 01 [Epub ahead of print]

S Ojeda, M Lloret, A Naranjo, F Déniz, N Chesa, C Domínguez, P C Lara

Servicio de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España. Electronic address: ., Servicio de Oncología Radioterápica, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España., Servicio de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España., Servicio de Urología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España., Servicio de Urología, Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Las Palmas de Gran Canaria, España., Servicio de Análisis Clínico, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España.

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