title: Does anastrozole affect bone resorption similarly in early and late postmenopausal women?
abstract: The aim of this study was to determine whether the bone-resorption response to anastrozole differed according to initial patient age in postmenopausal women with breast cancer in a cross-sectional study. Second-morning void urines were collected for measurement of urinary cross-linked N-telopeptide of type I collagen (uNTx, corrected for creatinine and log-transformed) from postmenopausal women, 99 with breast cancer on anastrozole (ABC), 88 with newly diagnosed breast cancer (NDBC), and 137 community-dwelling healthy control (HC) women. Bone mineral density (BMD) was also measured at the lumbar spine (LS, L2-L4) and the femoral neck (FN) in the ABC group. uNTx (nanomole bone collagen equivalents/millimole creatinine) levels increased with age in HC subjects. In patients <70 years, anastrozole treatment led to a significant increase in uNTx compared with age-related HC subjects (1.74 vs. 1.55, P < 0.005). Patients >70 years showed no such increase compared to HC (1.72 vs. 1.69, nonsignificant); however, NDBC women >70 years had uNTx levels significantly lower than HC women (1.59 vs. 1.69, P < 0.05). There was no difference in uNTx levels above and below the age of 70 years in NDBC women (1.56 vs. 1.59, nonsignificant). ABC women were more likely to have a positive LS BMD z score than age-matched controls. Anastrozole treatment increases bone turnover more in younger postmenopausal women with breast cancer than in older women compared to healthy controls. Higher LS BMD in ABC patients may help protect against fracture.
authors.affiliation: Charles Salt Centre for Human Metabolism, Robert Jones & Agnes Hunt Orthopaedic & District Hospital NHS Trust, Oswestry, Shropshire, UK. diane.powell@rjah.nhs.uk
authors.forename: Diane E
authors.initials: DE
authors.lastname: Powell
authors.forename: Richard A
authors.initials: RA
authors.lastname: Cochrane
authors.forename: Michael W J
authors.initials: MW
authors.lastname: Davie
mesh_terms: D000367:Age Factors; D000368:Aged; D000077384:Anastrozole; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects; D001862:Bone Resorption / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D001943:Breast Neoplasms / Q000188:drug therapy / Q000503:physiopathology / Q000652:urine; D002277:Carcinoma / Q000188:drug therapy / Q000503:physiopathology / Q000652:urine; D016022:Case-Control Studies; D024042:Collagen Type I / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009570:Nitriles / Q000009:adverse effects* / Q000494:pharmacology* / Q000627:therapeutic use; D015663:Osteoporosis, Postmenopausal / Q000139:chemically induced / Q000209:etiology / Q000652:urine; D010455:Peptides / Q000652:urine; D017698:Postmenopause / Q000187:drug effects* / Q000502:physiology; D012307:Risk Factors; D014230:Triazoles / Q000009:adverse effects* / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D018931:Antineoplastic Agents, Hormonal; D024042:Collagen Type I; D009570:Nitriles; D010455:Peptides; D014230:Triazoles; C052929:collagen type I trimeric cross-linked peptide; D000077384:Anastrozole