Fracture incidence after 3 years of aromatase inhibitor therapy
| Autor: | Maurice Audran, S. Abadie-Lacourtoisie, E. Legrand, S. Vinchon-Petit, Daniel Chappard, C. Lassalle, M. Georgin-Mege, M. Royer, C. Tuchais, Emmanuel Hoppé, E. Jadaud, P. Soulié, N. Mesgouez-Nebout, P. Cellier, Béatrice Bouvard |
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| Přispěvatelé: | Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Groupe d'Études Remodelage Osseux et bioMatériaux (GEROM), Université d'Angers (UA) |
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Bone density medicine.drug_class medicine.medical_treatment [SDV]Life Sciences [q-bio] Osteoporosis 030209 endocrinology & metabolism Breast Neoplasms 03 medical and health sciences Fractures Bone 0302 clinical medicine Breast cancer Bone Density Internal medicine medicine Humans Bone Aged Bone mineral Aromatase inhibitor business.industry Aromatase Inhibitors Incidence (epidemiology) Age Factors Hematology Bisphosphonate Middle Aged medicine.disease Surgery Osteopenia Postmenopause Oncology 030220 oncology & carcinogenesis Female business Fractures |
| Zdroj: | Annals of Oncology Annals of Oncology, 2014, 25 (4), pp.843-847. ⟨10.1093/annonc/mdu008⟩ |
| ISSN: | 1569-8041 |
| DOI: | 10.1093/annonc/mdu008⟩ |
| Popis: | International audience; BACKGROUND: The purpose of this study was to describe the fracture incidence and bone mineral density (BMD) evolution in a large cohort of post-menopausal women with breast cancer after 3 years of aromatase inhibitor (AI) therapy.PATIENTS AND METHODS: A prospective, longitudinal study in real-life setting. Each woman had an extensive medical assessment, a biological evaluation, a BMD measurement, and systematic spinal X-rays at baseline and after 3 years of AI therapy. Women with osteoporosis at baseline (T-score < -2.5 and/or non-traumatic fracture history) were treated by oral weekly bisphosphonates.RESULTS: Among 497 women (mean age 63.8 ± 9.6 years) included in this study, 389 had a bone evaluation both at baseline and after 3 years of AI therapy: 267 women (mean age 61.2 ± 8.6) with no osteoporosis at baseline and 122 women (mean age 67.2 ± 9.1) with osteoporosis at baseline justifying a weekly oral bisphosphonate treatment. Women without bisphosphonates had a significant decrease in spine BMD (-3.5%, P < 0.01), neck BMD (-2.0%, P < 0.01), and total hip BMD (-2.1%, P < 0.01) over the 3 years but only 15 of them (5.6%) presented an incident vertebral or non-vertebral fracture. In osteoporotic women treated with bisphosphonates, spine and hip BMD were maintained at 3 years but 12 of them (9.8%) had an incident fracture. These fractured women were significantly older (74.1 ± 9.8 versus 66.5 ± 8.8) but also presented BMD loss during treatment suggesting poor adherence to bisphosphonate treatment.CONCLUSION: This real-life study confirmed that AIs induced moderate bone loss and low fracture incidence in post-menopausal women without initial osteoporosis. In women with baseline osteoporosis and AI therapy, oral bisphosphonates maintain BMD but were associated with a persistent fracture risk, particularly in older women. |
| Databáze: | OpenAIRE |
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