Androgen-Deprivation Therapy Spikes Fracture Risk in Elderly
Risk especially high for prostate cancer patients 75 or older on ADT for more than 24 months
WEDNESDAY, Nov. 10 (HealthDay News) -- Older men on long-term androgen-deprivation therapy (ADT) are at substantially increased risk for bone fractures, according to a study presented at the American Association for Cancer Research's Frontiers in Cancer Prevention Research Conference, held from Nov. 7 to 10 in Philadelphia.
Joni Y. Shao, Ph.D., of the Cancer Institute of New Jersey in New Brunswick, and colleagues analyzed data from the Surveillance, Epidemiology, and End Results-Medicare program for 46,587 men diagnosed with localized prostate cancer who had survived at least five years after diagnosis. The researchers estimated the risk of fracture among men who received ADT long term.
The researchers found that men who received 36 or more doses of gonadotropin-releasing hormone (Gn-RH) agonist had a 47 percent higher risk of hospitalization for fracture. After two years of ADT, men had a 57.8 percent higher risk of multiple fractures. Fracture risk increased with older age, higher comorbidity, history of fracture, and stroke. Men 75 years of age or older who received Gn-RH agonist for more than 24 months had a nearly four-fold increased risk of fracture (hazard ratio, 3.63) compared to men aged 66 to 74 on ADT for less than 24 months. In addition, men who had undergone orchiectomy had a 75 percent higher risk of hospitalization for fracture.
"Treating men who have pre-existing conditions with longer duration of ADT exacerbates their risk of fracture, and becomes more pronounced over time," a study co-author said in a statement. "Careful evaluation of the patient's risk of fracture, while initiating treatment, is important because fracture has a strong impact on quality of life and mortality."