MP78-04 ORAL AND INTRAVENOUS BISPHOSPHONATE USE FOLLOWING ANDROGEN DEPRIVATION THERAPY AMONG MEDICARE BENEFICIARIES WITH NON-METASTATIC PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History III1 Apr 2014MP78-04 ORAL AND INTRAVENOUS BISPHOSPHONATE USE FOLLOWING ANDROGEN DEPRIVATION THERAPY AMONG MEDICARE BENEFICIARIES WITH NON-METASTATIC PROSTATE CANCER Candice Yong, Eberechukwu Onukwugha, C. Daniel Mullins, Ilene Zuckerman, Arif Hussain, and Michael Naslund Candice YongCandice Yong More articles by this author , Eberechukwu OnukwughaEberechukwu Onukwugha More articles by this author , C. Daniel MullinsC. Daniel Mullins More articles by this author , Ilene ZuckermanIlene Zuckerman More articles by this author , Arif HussainArif Hussain More articles by this author , and Michael NaslundMichael Naslund More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2487AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Androgen deprivation therapy (ADT) in prostate cancer (PC) is associated with significant bone loss and an increase in fracture risk. Current guidelines for men receiving ADT recommend screening for bone loss and initiating intravenous (IV) or oral bisphosphonate (BP) therapy in patients with fracture risk factors to attenuate cancer treatment-induced bone loss (CTIBL). Prior reports of BP use among elderly Medicare patients with PC have focused on IV BP use and hence may underestimate overall use of BP in this population. We estimated the prevalence of both oral and IV BP use following ADT initiation among elderly Medicare patients with non-metastatic PC. METHODS Using linked Surveillance, Epidemiology, and End Results (SEER) & Medicare data, we identified men aged 66+ with incident non-metastatic PC diagnosed during 2007-2009 (after the Medicare prescription drug benefit Part D was enacted in 2006). Patients were included if they received ADT within 6 months following diagnosis and had at least 6 months of Part D enrollment during follow-up. Claims data from 2006-2010 were used to characterize the prevalence of oral and IV BP use prior to and after ADT initiation. We also evaluated the prevalence of BP use in two subgroups of patients with baseline fracture risk factors: 1) diagnosis of osteoporosis, and 2) history of fracture in the one year prior to diagnosis. RESULTS The final sample included 7,545 non-metastatic PC patients who received ADT. The prevalence of any BP, oral BP, and IV BP use after ADT initiation was 8.2%, 5.2%, and 3.3% respectively. The median time to oral and IV BP use after ADT initiation was 140 days and 264 days, respectively. A small proportion (1.4%) of the sample had any BP use prior to ADT initiation and 91% of these men received oral BP. Among those with BP use prior to ADT, the median time between BP use and ADT initiation was 17 days (oral) and 20 days (IV). During the one year prior to PC diagnosis, 90 (1.2%) men had claims-based evidence of osteoporosis, of whom 51 (56.7%) received any BP post-ADT. At the same time, 290 (3.8%) men had a history of fracture at baseline, of whom 35 (12.1%) received any BP post-ADT. CONCLUSIONS Fewer than 1 in 10 men diagnosed with PC and initiating ADT received either oral or IV BP. Use of BP was relatively higher among men with baseline osteoporosis but lower than expected among men with a history of fracture. These results suggest that a significant gap remains in the prevention and treatment of CTIBL in this population of PC patients undergoing ADT. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e922 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Candice Yong More articles by this author Eberechukwu Onukwugha More articles by this author C. Daniel Mullins More articles by this author Ilene Zuckerman More articles by this author Arif Hussain More articles by this author Michael Naslund More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...