Changes in bone and lipid metabolism in postmenopausal women with early breast cancer after terminating 2-year treatment with exemestane: a randomised, placebo-controlled study.
Aromatase inhibitors improve relapse-free survival in early breast cancer, but there is concern about possible detrimental effects on bone mineral density (BMD) and plasma lipids. This paper presents the results of a 2-year study evaluating the effects of exemestane versus placebo on BMD, bone markers, plasma lipids and coagulation factors, including a 1-year follow-up after termination of treatment in 147 patients. During treatment, the mean annual rate of loss of BMD in the lumbar spine was 2.17% in the exemestane group versus 1.84% in the placebo group (n.s.) and 2.72% versus 1.48%, respectively, in the femoral neck (P=0.024). A loss of BMD above that expected in both arms of this study could be due to low vitamin D status (88% of all patients had vitamin D levels <30 ng/ml). The changes observed with exemestane were partially reversed during a 1-year follow-up, with no significant difference between the two arms. Similarly, the moderate decrease in high-density lipoprotein (HDL)-cholesterol was reversed. The bone marker values decreased, although a difference at 6 months of follow-up was still recorded, in particular for the markers of bone synthesis.
Geisler
J
J
Section of Oncology, Department of Medicine, Haukeland University Hospital, University of Bergen, NO-5021, Bergen, Norway.
Lønning
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Krag
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Løkkevik
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Risberg
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Hagen
A I
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Schlichting
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Lien
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Ofjord
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Eide
G E
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Polli
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di Salle
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Paolini
J
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D000730:Androstadienes / Q000009:adverse effects*; D047072:Aromatase Inhibitors / Q000009:adverse effects*; D015415:Biomarkers / Q000378:metabolism; D001779:Blood Coagulation Factors / Q000378:metabolism; D015519:Bone Density / Q000187:drug effects*; D016723:Bone Remodeling; D001842:Bone and Bones / Q000378:metabolism; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D012739:Gonadal Steroid Hormones / Q000097:blood; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D017698:Postmenopause; D014807:Vitamin D / Q000097:blood; D028761:Withholding Treatment
D000730:Androstadienes; D047072:Aromatase Inhibitors; D015415:Biomarkers; D001779:Blood Coagulation Factors; D012739:Gonadal Steroid Hormones; D008055:Lipids; D006710:Homocysteine; D014807:Vitamin D; C056516:exemestane