title: The benefits of timely intervention with zoledronic acid in patients with metastatic prostate cancer to bones: a retrospective study of the US Veterans Affairs population.
abstract: To examine the effect of timely zoledronic acid (ZA) treatment on clinical outcomes and health care utilization in patients with bone-metastatic prostate cancer. Patients with prostate cancer and bone metastasis were identified in a Veterans Affairs database (01/2002-09/2009). Eligible patients had no documented skeletal-related events (SREs) before the index date (that is, the first bone metastasis diagnosis date). Patients who received early ZA treatment, defined as having a ZA infusion after the index date and before any recorded SREs, were matched 1:1 on propensity score to patients not treated with bisphosphonates (BPs). Risks of SREs, hospitalization and death during the 6-month post-index period were compared between matched cohorts using Kaplan-Meier analyses. Baseline characteristics were well balanced between the matched cohorts (n = 73 per group). 6-month SRE-free survival and hospitalization-free survival were higher in patients receiving timely ZA than patients without BP treatment (91.7 versus 71.5%, P < 0.01; 80.5 versus 66.3%, P = 0.05, respectively). 6-month mortality risk was significantly lower in patients treated with ZA versus those without BP treatment (4.3 versus 13.8%, P = 0.04). Timely ZA intervention in bone-metastatic prostate cancer patients was associated with significant reductions in 6-month risks of SREs, hospitalization and mortality, as compared with no BP treatment.
authors.affiliation: Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA.
authors.forename: N V
authors.initials: NV
authors.lastname: Velde
authors.forename: E Q
authors.initials: EQ
authors.lastname: Wu
authors.forename: A
authors.initials: A
authors.lastname: Guo
authors.forename: M
authors.initials: M
authors.lastname: Lu
authors.forename: A P
authors.initials: AP
authors.lastname: Yu
authors.forename: H
authors.initials: H
authors.lastname: Sharma
authors.forename: J
authors.initials: J
authors.lastname: Liu
authors.forename: C P S
authors.initials: CP
authors.lastname: Fan
authors.forename: L
authors.initials: L
authors.lastname: Shi
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D004164:Diphosphonates / Q000008:administration & dosage*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D014493:United States Department of Veterans Affairs; D000077211:Zoledronic Acid
chemical_list: D000970:Antineoplastic Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid