loading page

Efficacy of Denosumab in Bone Mineral Density Evolution in Patients with Prostate Cancer under Different Schemes of Androgen Deprivation Therapy: A Real-World Setting Study
  • +3
  • Karla Arevalo Ruales,
  • José Ivorra Cortés,
  • Elena Grau García,
  • Cesar David Vera Donoso,
  • José Antonio Cañada Martínez,
  • José Andrés Román Ivorra
Karla Arevalo Ruales
RKH Neuenbürg

Corresponding Author:[email protected]

Author Profile
José Ivorra Cortés
Hospital La Fe
Author Profile
Elena Grau García
Hospital La Fe
Author Profile
Cesar David Vera Donoso
Hospital La Fe
Author Profile
José Antonio Cañada Martínez
Hospital La Fe Investigation Centre
Author Profile
José Andrés Román Ivorra
Hospital La Fe
Author Profile

Abstract

Rationale, Aims and Objectives: Antiresorptive treatment in androgen deprivation therapy (ADT) has proved effective in clinical trials, however its real-world efficacy has not been reported. Furthermore, different schemes of ADT are available and its effect on bone health is still under study. The objectives of this research is are to evaluate the basal and evolution of bone health of patients with prostate cancer receiving different schemes of luteinizing hormone-releasing hormone (LH-RH) agonists. Furthermore, to assess the effect of antiresorptive treatment in a real-world setting. Material and Methods: A 24-month longitudinal observational study with a standardized clinical practice was conducted. Demographics, osteoporosis risk factors, LH-RH treatment regimen, osteoporosis treatment were collected. Laboratory tests and BMD were compiled. Antiresorptive treatment compliance was reviewed in a post-hoc study. Results: 83 patients (mean age 71 ± 8 years) completed basal evaluation. 57 patients completed 24-month follow-up. At the basal evaluation, 80% of patients had inadequate vitamin D levels. Vitamin D >30 ng/mL was correlated with higher T-scores. Continuous LH-RH agonists scheme was associated with a decrease in BMD, especially at the total hip. Adding antiresorptive treatment was correlated to statistically significant better BMD evolution in patients under continuous LH-RH agonist scheme. Patients with intermittent LH-RH treatment and without antiresorptive treatment showed a better evolution at femoral neck BMD. More than one-third of patients under LH-RH intermittent scheme had problems with compliance of denosumab. Conclusion: Bone health assessment in patients with LH-RH agonist treatment is essential. Inadequate vitamin D levels were commonly presented in our patients, suggesting that bone health evaluation in these patients is still underperformed. Intermittent LH-RH scheme and antiresorptive treatment correlated to a better evolution of BMD. Denosumab patients’ non-compliance can become a problem in patients under intermittent LH-RH scheme, which could lead to a decrease of its efficacy.