title: Effects of denosumab on bone mineral density in men receiving androgen deprivation therapy for prostate cancer.
abstract: OBJECTIVE
  In a recently completed 3-year, randomized, double-blind study, denosumab, a fully human monoclonal antibody against receptor activator of nuclear factor kappaB ligand, significantly increased bone mineral density and decreased new vertebral fractures in men receiving androgen deprivation therapy for prostate cancer. We conducted subgroup analyses to evaluate the relationships between subject characteristics and the effects of denosumab on bone mineral density at multiple skeletal sites.
  
  
  METHODS
  A total of 1,468 subjects were randomized 1:1 to receive 60 mg subcutaneous denosumab every 6 months or placebo for 36 months. In these analyses we evaluated the effects of denosumab on bone mineral density at the lumbar spine, total hip and distal 1/3 radius (substudy of 309 subjects) during 36 months in specific subgroups according to age, duration and type of prior androgen deprivation therapy, bone mineral density T score, weight, body mass index, bone turnover marker levels and prevalent vertebral fractures.
  
  
  RESULTS
  After 36 months denosumab significantly increased bone mineral density of the lumbar spine, total hip and distal 1/3 radius by 7.9%, 5.7% and 6.9%, respectively, compared with placebo (p <0.0001 for each comparison). Denosumab significantly increased bone mineral density to a degree similar to that observed in the overall analysis for every subgroup including older men as well as those with prevalent fractures, lower baseline bone mineral density, and higher serum C-telopeptide and tartrate-resistant alkaline phosphatase 5b. Mean increases in bone mineral density at each skeletal site were greatest for men with the highest levels of serum C-telopeptide and tartrate-resistant alkaline phosphatase 5b.
  
  
  CONCLUSIONS
  Denosumab significantly and consistently increased bone mineral density at all skeletal sites and in every subgroup, including men at greatest risk for bone loss and fractures.
authors.affiliation: Massachusetts General Hospital Cancer Center, Boston, Massachusetts 02114, USA. smith.matthew@mgh.harvard.edu
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Smith
authors.forename: Fred
authors.initials: F
authors.lastname: Saad
authors.forename: Blair
authors.initials: B
authors.lastname: Egerdie
authors.forename: Maciej
authors.initials: M
authors.lastname: Szwedowski
authors.forename: Teuvo L J
authors.initials: TL
authors.lastname: Tammela
authors.forename: Chunlei
authors.initials: C
authors.lastname: Ke
authors.forename: Benjamin Z
authors.initials: BZ
authors.lastname: Leder
authors.forename: Carsten
authors.initials: C
authors.lastname: Goessl
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000009:adverse effects; D000911:Antibodies, Monoclonal / Q000494:pharmacology*; D061067:Antibodies, Monoclonal, Humanized; D015519:Bone Density / Q000187:drug effects*; D000069448:Denosumab; D004311:Double-Blind Method; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy / Q000009:adverse effects; D011471:Prostatic Neoplasms / Q000628:therapy; D053245:RANK Ligand / Q000494:pharmacology*
chemical_list: D000726:Androgen Antagonists; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D053245:RANK Ligand; D007987:Gonadotropin-Releasing Hormone; D000069448:Denosumab