Abstract

Background. Loss of bone density with androgen deprivation therapy for prostate cancer is well recognized. We assessed the effects of quarterly infusion of zoledronic acid on bone mineral density (BMD) and markers of bone turnover over a one-year period in men receiving gonadotropin-releasing hormone analog (GnRH-a) for prostate cancer. Methods. 41 subjects were randomly assigned to treatment with zoledronic acid (4 mg) IV infusion or placebo every 3 months. The primary endpoint was the change in the lumbar spine BMD after 12 months of treatment. Results. The change in vertebral BMD in the zoledronic acid group (+7.93 ± 1.4%) was significantly (P < .05) greater than the change in the placebo group (+0.82 ± 1.7%) as was the change in left femoral neck BMD (+5.05 ± 1.4% for the zoledronic acid group versus −0.48 ± 1.4% for the placebo group). The decrease in biochemical markers of bone turnover was significantly (P < .05) greater in the zoledronic acid group compared to the placebo group. Conclusion. Quarterly infusion of zoledronic acid for 1 year improved vertebral and left femoral neck BMD with a decrease in bone turnover markers in men on GnRH-a treatment. Zoledronic acid treatment appears to be promising in men with low BMD receiving GnRH-a treatment.

Highlights

  • Prostate cancer is the most common visceral malignancy and the second leading cause of death from cancer in men [1]

  • We assessed the effects of quarterly infusion of zoledronic acid on bone mineral density (BMD) and markers of bone turnover over a one-year period in men receiving gonadotropin-releasing hormone analog (GnRH-a) for prostate cancer

  • Baseline and Followup. 21 patients were assigned to the zoledronic acid group, and 20 patients were assigned to the placebo group. 10 patients were excluded in the analysis of BMD (4 in the zoledronic acid group and 6 in the placebo group)

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Summary

Introduction

Prostate cancer is the most common visceral malignancy and the second leading cause of death from cancer in men [1]. There are several studies showing the effect of GnRH-a treatment on bone mineral density and bone metabolism in men with prostate cancer [4,5,6]. GnRH-a treatment results in reduction in bone mineral density (BMD) and elevation in biochemical markers of bone turnover. Double-blind, placebo controlled study to evaluate the effect of zoledronic acid on BMD and biochemical markers of bone turnover in men receiving androgen deprivation therapy for prostate cancer. We assessed the effects of quarterly infusion of zoledronic acid on bone mineral density (BMD) and markers of bone turnover over a one-year period in men receiving gonadotropin-releasing hormone analog (GnRH-a) for prostate cancer. Infusion of zoledronic acid for 1 year improved vertebral and left femoral neck BMD with a decrease in bone turnover markers in men on GnRH-a treatment. Zoledronic acid treatment appears to be promising in men with low BMD receiving GnRH-a treatment

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