Risedronate prevents early bone loss and increased bone turnover in the first 6 months of luteinizing hormone-releasing hormone-agonist therapy for prostate cancer.
OBJECTIVE
To determine whether increased bone loss and bone turnover during the first 6 months of therapy for prostate cancer with luteinizing hormone-releasing hormone (LHRH)-agonist therapy could be prevented by bisphosphonate therapy with risedronate 35 mg/week, as prostate cancer is commonly treated with LHRH agonists and this often leads to rapid bone loss within the first 6 months of therapy.


METHODS
A 6-month randomized, double-blind, placebo-controlled trial was conducted, including 40 men aged ≥ 55 years receiving LHRH-agonist treatment for 6 months for locally advanced prostate cancer. Bone mineral density (BMD) of the lumbar spine, femoral neck, and total hip was measured every 6 months. In addition, bone turnover markers including N-telopeptide, serum C-telopeptide and procollagen peptide, and 25-OH vitamin D and intact parathyroid hormone were measured at baseline and at 6 months.


RESULTS
After 6 months of LHRH-agonist therapy, the control group had a significant decline at the spine and hip BMD sites; however, the risedronate group had no bone loss at the hip and an increase at the lumber spine. Markers of bone turnover were increased significantly in the control group but unchanged in the risedronate group.


CONCLUSIONS
LHRH-agonist treatment for locally advanced prostate cancer produces increased bone turnover and rapid bone loss within the initial 6 months of therapy, and this can be prevented by weekly risedronate treatment.
Taxel
Pamela
P
Department of Medicine, Radiation Oncology, Surgery and General Clinical Research Center, University of Connecticut Health Center, Farmington, CT 06030-5456, USA. taxel@nso.uchc.edu
Dowsett
Robert
R
Richter
Lee
L
Fall
Pamela
P
Klepinger
Alison
A
Albertsen
Peter
P
D000368:Aged; D000726:Androgen Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D000728:Androgens / Q000378:metabolism; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D004812:Epidemiologic Methods; D012968:Etidronic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000517:prevention & control*; D011471:Prostatic Neoplasms / Q000150:complications / Q000188:drug therapy*; D000068296:Risedronic Acid; D016896:Treatment Outcome
D000726:Androgen Antagonists; D000728:Androgens; D050071:Bone Density Conservation Agents; D007987:Gonadotropin-Releasing Hormone; D000068296:Risedronic Acid; D012968:Etidronic Acid