Single infusion of zoledronic acid to prevent androgen deprivation therapy-induced bone loss in men with hormone-naive prostate carcinoma.
BACKGROUND
Androgen-deprivation therapy (ADT) decreases bone mineral density (BMD) and increases fracture risk in patients with prostate carcinoma. The authors investigated the effectiveness of a single infusion of zoledronic acid initiated subsequent to ADT on BMD with hormone-naive prostate carcinoma.


METHODS
Forty men received either a single infusion of zoledronic acid (4 mg intravenously on Day 1) or no infusion during ADT. BMD of the proximal femur and posteroanterior lumbar spine was measured by dual-energy x-ray absorptiometry and urinary N-telopeptide (u-NTx) at 6 and 12 months.


RESULTS
At baseline, the overall BMDs demonstrated no significant difference in lumbar spine and hip regions. At 6 months, mean (+/-standard error) BMD of the posteroanterior lumbar spine decreased 4.6%+/-1.0% in control patients and increased 5.1%+/-1.2% in patients receiving zoledronic acid, a significant difference (P=.0002). At 12 months, the change in BMD between the 2 groups was statistically significantly different at the lumbar region (P=.0004), indicating that zoledronate preserved BMD. For u-NTx, bone turnover was statistically significantly decreased in the zoledronate group compared with controls at 6 months (P<.0001), but returned to pretreatment levels at 12 months in the zoledronate group.


CONCLUSIONS
Bone loss begins at 6 months with ADT. A single infusion of zoledronic acid in patients receiving ADT reduces bone mineral loss and maintains BMD at least at 12 months during ADT. Further study is needed to determine the best dosing schedule to prevent ADT-induced bone loss in men with hormone-naive prostate carcinoma.
Satoh
Takefumi
T
Department of Urology, Kitasato University School of Medicine, Kanagawa, Japan. tsatoh@kitasato-u.ac.jp
Kimura
Masaki
M
Matsumoto
Kazumasa
K
Tabata
Ken-ichi
K
Okusa
Hiroshi
H
Bessho
Hideharu
H
Iwamura
Masatsugu
M
Ishiyama
Hiromichi
H
Hayakawa
Kazushige
K
Baba
Shiro
S
D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000009:adverse effects*; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D001851:Bone Diseases, Metabolic / Q000139:chemically induced / Q000517:prevention & control*; D004164:Diphosphonates; D006801:Humans; D007093:Imidazoles; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011471:Prostatic Neoplasms / Q000150:complications / Q000188:drug therapy*; D000077211:Zoledronic Acid
D000726:Androgen Antagonists; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid