- Bisphosphonates increased bone mineral density (BMD) in men with nonmetastatic prostate cancer who received androgen deprivation therapy (ADT).
- Denosumab increased BMD and also reduced risk for fracture in these men.
Why this matters
- ADT is associated with risk for reduction in bone density and increased fracture.
- This systematic review of drugs, supplements, and lifestyle interventions by the Genitourinary Cancer Disease Site Group of the Cancer Care Ontario (CCO) will help physicians effectively manage patients at risk.
- At 12 mo, bisphosphonates vs placebo increased BMD at the lumbar spine (mean difference [MD], 6.3%; P<.001), femoral neck (MD, 3.0%; P<.001), and total hip (MD, 2.7%; P< .001).
- Denosumab vs placebo reduced new radiographic vertebral fractures at 12 mo (relative risk [RR], 0.15; P=.004), 24 mo (RR, 0.31; P=.004), and 36 mo (RR, 0.38; P=.006).
- Raloxifene, toremifene, and denosumab showed statistical improvement in BMD.
- No significant improvement in BMD was seen with exercise interventions.
- 2 systematic reviews and 27 eligible randomized controlled trials till January 2017 were evaluated.
- Funding: Cancer Care Ontario.
- Studies on bisphosphonates were underpowered to detect effects on fracture.