HealthDay News — For men with nonmetastatic prostate cancer who are receiving androgen deprivation therapy (ADT), bisphosphonates and denosumab improve bone mineral density (BMD), according to a review published online in the Annals of Internal Medicine.
Shabbir MH Alibhai, MD, from the University of Toronto, and colleagues reviewed data from 2 systematic reviews and 28 reports of 27 trials to assess the effectiveness of drug, supplement, and lifestyle interventions aimed at preventing fracture, improving BMD, or preventing or delaying osteoporosis in men with nonmetastatic prostate cancer. All trials focused on men who were initiating or continuing ADT.
The researchers found that BMD was effectively increased with bisphosphonates, but no trial was sufficiently powered to detect a decrease in fractures. Improvement in BMD was seen with denosumab, which also reduced the incidence of new radiographic vertebral fractures in one high-quality trial.
Calcium or vitamin D were not compared with placebo in any of the trials. There was no statistically significant change in BMD between exercise and usual care in three lifestyle intervention trials.
“Both bisphosphonates and denosumab improve BMD in men with nonmetastatic prostate cancer who are receiving ADT,” the authors write. “More trials studying fracture outcomes are needed in this population.”
Several authors disclosed financial ties to the pharmaceutical industry.
Alibhai SMH, Zukotynski K, Walker-Dilks C, et al. Bone health and bone-targeted therapies for nonmetastatic prostate cancer: A systematic review and meta-analysis [published online August 8, 2017]. Ann Intern Med. doi:10.7326/M16-2577