132 SARCOPENIA IN MEN RECEIVING ANDROGEN DEPRIVATION THERAPY (ADT) FOR PROSTATE CANCER: A PROSPECTIVE 3-YEAR STUDY

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You have accessJournal of UrologyProstate Cancer: Epidemiology and Natural History I1 Apr 2010132 SARCOPENIA IN MEN RECEIVING ANDROGEN DEPRIVATION THERAPY (ADT) FOR PROSTATE CANCER: A PROSPECTIVE 3-YEAR STUDY Matthew R. Smith, Fred Saad, Blair Egerdie, Paul Sieber, Teuvo L.J. Tammela, Amy Kupic, Chunlei Ke, Benjamin Z. Leder, and Carsten Goessl Matthew R. SmithMatthew R. Smith Boston, MA More articles by this author , Fred SaadFred Saad Montreal, Canada More articles by this author , Blair EgerdieBlair Egerdie Kitchener, Canada More articles by this author , Paul SieberPaul Sieber Lancaster, PA More articles by this author , Teuvo L.J. TammelaTeuvo L.J. Tammela Tampere, Finland More articles by this author , Amy KupicAmy Kupic Thousand Oaks, CA More articles by this author , Chunlei KeChunlei Ke Thousand Oaks, CA More articles by this author , Benjamin Z. LederBenjamin Z. Leder Boston, MA More articles by this author , and Carsten GoesslCarsten Goessl Thousand Oaks, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.183AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Androgen deprivation therapy (ADT) for prostate cancer decreases bone mineral density and increases fracture risk. Studies with limited sample size and observational periods have reported that ADT is also associated with sarcopenia or loss of muscle (lean body mass, LBM). In a recently reported 3-year randomized, placebo-controlled phase III trial of men receiving ADT for nonmetastatic prostate cancer (n=1468), the fully human anti-RANKL monoclonal antibody denosumab significantly increased bone mineral density and reduced risk for new vertebral fractures (Smith, MR et al. New Engl J Med. 2009;361:745-755). We now report the prospective changes in LBM in a subset of men from that study. METHODS Men undergoing ADT for nonmetastatic prostate cancer at 38 centers in North America were randomized to denosumab or placebo. A total of 248 subjects (130 denosumab, 118 placebo) with a baseline and with at least 1 on-study LBM result were considered evaluable and included in this analysis. Most were white or Hispanic (mean age 75 years). Subjects were stratified at baseline by age (<70 years vs ≥70 years) and by duration of ADT treatment (≤6 months vs >6 months). All subjects were also to receive daily supplemental calcium and vitamin D. LBM was measured by total body dual-energy x-ray absorptiometry at baseline and at 12, 24, and 36 months. Because no significant differences in LBM were seen between study arms, data were pooled for this analysis. RESULTS From baseline to month 12, mean LBM decreased significantly by 1.0% (95% CI: 1.5%, 0.4%; p=.0004). Significant decreases (mean [95% CI]) in LBM were also observed at month 24 (2.1% [2.7%, 1.5%], p<.0001; n=205) and month 36 (2.4% [3.2%, 1.6%], p<.0001; n=168). Men aged ≥70 years (n=127) had significantly greater changes in LBM at all measured time points. At 36 months, LBM decreased by 2.8% in men aged ≥70 years compared with a decrease of 0.9% in younger men (p=0.035). Men with ≤6 months of ADT at study entry (n=36) had a greater rate of decrease in LBM compared with men who had received >6 months of ADT at study entry (3.7% vs 2.0%; p=.0645). CONCLUSIONS With 248 evaluable subjects and 3 years follow-up duration, this is the largest and longest prospective study undertaken to describe the natural history of muscle loss in men undergoing ADT therapy for prostate cancer. LBM significantly decreased at 12, 24, and 36 months. Decreases in LBM were greatest in older men and in those who had short duration of ADT at study entry. These observations highlight the importance of treatment-related sarcopenia in prostate cancer survivors. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e54 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew R. Smith Boston, MA More articles by this author Fred Saad Montreal, Canada More articles by this author Blair Egerdie Kitchener, Canada More articles by this author Paul Sieber Lancaster, PA More articles by this author Teuvo L.J. Tammela Tampere, Finland More articles by this author Amy Kupic Thousand Oaks, CA More articles by this author Chunlei Ke Thousand Oaks, CA More articles by this author Benjamin Z. Leder Boston, MA More articles by this author Carsten Goessl Thousand Oaks, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...