title: Osteoporosis management program decreases incidence of hip fracture in patients with prostate cancer receiving androgen deprivation therapy.
abstract: OBJECTIVE
  To evaluate the incidence of hip fracture in men with prostate cancer receiving androgen deprivation therapy (ADT).
  
  
  METHODS
  One of the detrimental side effects of ADT for prostate cancer is osteoporosis. Through an osteoporosis prevention program implemented in our healthcare system, the patients at risk undergo dual x-ray absorptiometry scans and receive treatment if the T-score indicates bone loss. We evaluated the incidence of hip fracture in men with prostate cancer who were receiving ADT through a retrospective, cohort study conducted within a managed care organization. The participants were all men newly diagnosed with prostate cancer from January 2003 to December 2007 receiving leuprolide injections. Patients who had had a dual x-ray absorptiometry scan beginning 3 months before the index date through the end of study were included in the intervention group; all others were included in the comparison group. The main outcome of interest was a hip fracture occurring after the index date, excluding cancer pathologic fractures, traumatic fractures, and fractures associated with epilepsy.
  
  
  RESULTS
  A total of 1071 patients were in the intervention group, and 411 were in the comparison group. In the intervention group, 18 hip fractures occurred compared with 17 in the comparison group. The incidence rate of hip fractures per 1000 person-years was 5.1 (95% confidence interval 3.0-8.0) in the intervention group and 18.1 (95% confidence interval 10.5-29.0) in the comparison group.
  
  
  CONCLUSIONS
  The incidence rate of hip fracture in this population was reduced >70% with enrollment in an osteoporosis management system, avoiding this morbid complication of ADT.
authors.affiliation: Department of Urology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA 90027, USA.
authors.forename: Ali-Asghar
authors.initials: AA
authors.lastname: Zhumkhawala
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Gleason
authors.forename: T Craig
authors.initials: TC
authors.lastname: Cheetham
authors.forename: Fang
authors.initials: F
authors.lastname: Niu
authors.forename: Ronald K
authors.initials: RK
authors.lastname: Loo
authors.forename: Richard M
authors.initials: RM
authors.lastname: Dell
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Jacobsen
authors.forename: Gary W
authors.initials: GW
authors.lastname: Chien
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D015519:Bone Density; D002140:California / Q000453:epidemiology; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D008297:Male; D010024:Osteoporosis / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D011471:Prostatic Neoplasms / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal