Abstract
PurposeWe investigated whether age at anastrozole (A) initiation influences the effect of treatment on bone mineral density (BMD). We conducted a post hoc analysis of the dataset of Arimidex Bone Mass Index Oral Bisphosphonates prospective trial, studying the effect of risedronate (R) on BMD of postmenopausal, early breast cancer patients receiving A.MethodsPatients were stratified into those with normal BMD or mild osteopenia (T > −2) receiving A-only and patients with mild or severe osteopenia (T ≤ −2) or osteoporosis (T < −2.5) receiving A and per os R (A + R). Depending on age on treatment initiation, patients were grouped into two age cohorts, above and below 65 years. BMD change in lumbar spine (LS) and hip (HP) was evaluated at 12 months. An analysis of patients with normal BMD at baseline was additionally performed.ResultsAmong patients receiving A-only, women ≤65 years were more likely to have a decrease in LS-BMD than older (p = 0.034). HP-BMD decrease at 12 months was not related to age (p = 0.182). In patients with mild or severe osteopenia or osteoporosis, treated with A + R, no age effect was observed for LS or HP (p = 0.099 and p = 0.939, respectively). Among patients with normal BMD at baseline, the age effect on LS-BMD change was more profound (p = 0.026).ConclusionsOur study suggests that younger postmenopausal women with normal BMD or mild osteopenia receiving A-only face an increased risk of bone loss in LS. Among patients with mild or severe osteopenia or osteoporosis treated with A + R, 12 months LS or HP BMD variations were configured regardless of age group.
Highlights
The principle treatment options for postmenopausal patients with hormone receptor (HR)-positive breast cancer are third-generation aromatase inhibitors (AIs) and selective estrogen receptor modulators (SERMs)
Purpose We investigated whether age at anastrozole (A) initiation influences the effect of treatment on bone mineral density (BMD)
Among patients receiving A-only, women B65 years were more likely to have a decrease in lumbar spine (LS)-BMD
Summary
The principle treatment options for postmenopausal patients with hormone receptor (HR)-positive breast cancer are third-generation aromatase inhibitors (AIs) and selective estrogen receptor modulators (SERMs). BPs inhibit bone resorption by interfering with osteoclast activation and by promoting osteoclast apoptosis (Body et al 1998; Fleisch 2002; Ashcroft et al 2003; Gnant and Eidtmann 2010). Clinical evidence supports their use as add-ons to AIs as a protective measure against osteoporosis (Gnant et al 2007; Brufsky et al 2009; Bundred et al 2008; Lester et al 2008; Van et al 2010)
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