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Previous Volume 345:948-955 September 27, 2001 Number 13 Next

	Full Text PDF Editorial by Dawson-Hughes, B. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Treatment with a gonadotropin-releasing hormone agonist decreases bone mineral density and increases the risk of fracture in men with prostate cancer. We conducted a controlled study of the prevention of osteoporosis in men undergoing treatment with a gonadotropin-releasing hormone agonist.

Methods In a 48-week, open-label study, we randomly assigned 47 men with advanced or recurrent prostate cancer and no bone metastases to receive either leuprolide alone or leuprolide and pamidronate (60 mg intravenously every 12 weeks). Bone mineral density of the lumbar spine and the proximal femur was measured by dual-energy x-ray absorptiometry. Trabecular bone mineral density of the lumbar spine was measured by quantitative computed tomography. Forty-one men completed the study.

Results In men treated with leuprolide alone, the mean (±SE) bone mineral density decreased by 3.3±0.7 percent in the lumbar spine, 2.1±0.6 percent in the trochanter, and 1.8±0.4 percent in the total hip, and the mean trabecular bone mineral density of the lumbar spine decreased by 8.5±1.8 percent (P<0.001 for each comparison with the base-line value). In contrast, the mean bone mineral density did not change significantly at any skeletal site in men treated with both leuprolide and pamidronate. There were significant differences between the two groups in the mean changes in bone mineral density at 48 weeks in the lumbar spine (P<0.001), trochanter (P=0.003), total hip (P=0.005), and trabecular bone of the lumbar spine (P=0.02).

Conclusions Pamidronate prevents bone loss in the hip and lumbar spine in men receiving treatment for prostate cancer with a gonadotropin-releasing hormone agonist.

Source Information

From Massachusetts General Hospital (M.R.S., F.J.M., A.L.Z., M.A.F., D.L.H., D.A.S., J.S.F.) and the Dana–Farber Cancer Institute (P.W.K.) — both in Boston.

Address reprint requests to Dr. Smith at Massachusetts General Hospital, Cox 640, 100 Blossom St., Boston, MA 02114, or at smith.matthew{at}mgh.harvard.edu.

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