AI-related BMD variation in actual practice conditions: A prospective cohort study

María Rodríguez-Sanz, Daniel Prieto-Alhambra, Sonia Servitja, Natalia Garcia-Giralt, Laia Garrigos, Jaime Rodriguez-Morera, Joan Albanell, Maria Martínez-García, Iria González, Adolfo Diez-Perez, Ignasi Tusquets, Xavier Nogués

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5 Citations (Scopus)

Abstract

© 2016 Society for Endocrinology. The aim of the study was to evaluate the progression of bone mineral density (BMD)during 3 years of aromatase inhibitors (AI)therapy in actual practice conditions.This prospective, clinical cohort study of Barcelona-Aromatase induced Bone Loss in Early breast cancer (B-ABLE)assessed BMD changes during 3 years of AI treatment in women with breast cancer.Patients with osteoporosis (T score < -2.5 or T score ≤ -2.0)and a major risk factor and/or prevalent fragility fractures were treated with oral bisphosphonates (BPs).Of 685 women recruited, 179 (26.1%)received BP treatment.By the third year of AI therapy, this group exhibited increased BMD in the lumbar spine (LS; 2.59%)and femoral neck (FN; 2.50%), although the increase was significant only within the first year (LS: 1.99% and FN: 2.04%).Despite BP therapy, however, approximately 15% of these patients lost more than 3% of their baseline bone mass.At 3 years, patients without BP experienced BMD decreases in the LS (-3.10%)and FN (-2.79%).In this group, BMD changes occurred during the first (LS: -1.33% and FN: -1.25%), second (LS: -1.19% and FN: -0.82%), and third (LS: -0.57% and FN: -0.65%)years of AI treatment.Increased BMD (>3%)was observed in just 7.6% and 10.8% of these patients at the LS and FN, respectively.Our data confirm a clinically relevant bone loss associated with AI therapy amongst nonusers of preventative BPs.We further report on the importance of BMD monitoring as well as calcium and 25-hydroxy Vitamin D supplementation in these patients.
Original languageEnglish
Pages (from-to)303-312
JournalEndocrine-Related Cancer
Volume23
Issue number4
DOIs
Publication statusPublished - 1 Apr 2016

Keywords

  • 25(OH)vitD
  • Aromatase inhibitors
  • Bisphosphonates
  • Bone loss
  • Breast cancer
  • Osteoporosis

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