THU427 The Benefits Of Oral Bisphosphonates For Elderly Patients With A History Of Long Term Aromatase Inhibitor Use

Abstract

Abstract Disclosure: L.D. Dominguez: None. S.E. Acosta: None. A.R. Alejandro: None. Aromatase Inhibitors (AI) are commonly used to treat estrogen receptor-positive breast cancer as they reduce the risk of recurrence and mortality. The AIs, however, can lead to a decrease in bone mineral density (BMD), resulting in fractures. According to the Journal of Bone Oncology (JBO), postmenopausal women on AIs with two or more risk factors for fractures should be placed on antiresorptive treatment (1). Our objective was to compare the BMD of at-risk patients that have been treated with antiresorptive treatment versus the BMD of patients not treated. An EMR chart review was conducted from 6/14/2022-8/20/2022, in which 295 patients were analyzed by the medications prescribed and their BMD. Our sample size was limited to 90 patients that had obtained DXA scores from the same GE Hologic densitometer. We hypothesized that patients on AIs and antiresorptive treatment would show more improvement in BMD than patients on AIs and not on treatment. Patients were analyzed in the comparison of their BMD. Of the 65 patients on AIs, only 17 were placed on antiresorptive treatment (26%). 94% of these patients showed improved BMD. The increase in BMD for the spine was significant (.030) as it exceeds the least significant change (LSC) of .027 g/cm^2. The improvement of .012 in the hip was not significant (.022 g/cm^2 LSC). 68.75% of patients on AI’s and not on treatment worsened by .025 in the hip (.022 g/cm^2 LSC) and by .017 in the spine (.027 g/cm^2 LSC). Alendronate (76%), Zoledronic acid (18%) and Ibandronate (6%) were commonly prescribed. The patients on Alendronate and Ibandronate, improved by .015 in the hip (.022 g/cm^2 LSC) and improved significantly by .028 in the spine (.027 g/cm^2 LSC). Patients on intravenous(IV) treatment improved significantly in the spine by .041(.027 g/cm^2 LSC) but only improved by .006 in the hip (.022 g/cm^2). Although IV administration of treatment is recommended for patients starting treatment (2), most patients showed a trend of improvement on oral bisphosphonates. Hence, to improve the care offered to at-risk patients who cannot obtain IV bisphosphonates, we can advocate for the use of oral bisphosphonate treatment.