Assessment of Aromatase Inhibitor‑Induced Bone Loss and Appropriateness of Supportive Therapy in Postmenopausal Breast Cancer Patients at a Tertiary Care Center

ABSTRACT

Objective: To assess aromatase inhibitor‑induced bone loss (AIBL) and its management in postmenopausal women (PMW) with breast cancer (BC). Materials and Methods: A cohort of 350 PMW with BC receiving aromatase inhibitors (AIs) during a span of 4 years was evaluated retrospectively. Bone mineral density (BMD) of the patients at lumbar spine (LS) and dual femur was monitored at baseline and annually for 2 years. Baseline fracture risk was evaluated using WHO fracture risk assessment tool. Results: At baseline, only 35.4% of the patients received supportive therapy such as calcium and Vitamin D supplements ± bisphosphonates. Significant decrease of mean BMD occurred at LS, left femur, and right femur (LF and RF) at 1 year (P < 0.001) in 64.6% of patients who did not receive supportive therapy at baseline. Those who received supportive therapy at baseline had a significant elevation of their mean BMD at LS, LF, and RF; (P < 0.001) at 1 year, and this increase in BMD persisted at 2 years. Ten‑year fracture risk at baseline was ‘high’ for 3.14% of patients, while 35.43% had ‘moderate risk’ of major osteoporotic fracture and 26.6% had ‘high risk’ of hip fracture. Overall incidence of fractures was 1.1% in patients who did not receive supportive therapy from baseline to 1 year. Conclusion: Majority of BC patients on AIs were not prescribed supportive therapy at baseline. Since AI monotherapy caused significant loss of LS and dual femur BMD at 1 year of treatment, up‑front supportive therapy should be started concurrently with AIs from baseline for the prevention of AIBL.

KEYWORDS

• Aromatase inhibitors
• bisphosphonates
• bone mineral density
• breast cancer
• calcium
• Vitamin D supplements

Showing references and in-text citations exactly as published.

Cite this article

• DOI10.4103/jpp.JPP_61_19Copy

RELATED ARTICLES

Matched on section and article type within this issue of J Pharmacol. Pharmacother..

• Article · VOLUME 10, ISSUE 4Online Videos as a Supplement Tool to Train II MBBS Students in Drug Administration SkillsSharmila V. Jalgaonkar, Raakhi K. Tripathi, Pankaj V. Sarkate, Santosh B. Salagre, Shobha M. Itolikar, Nirmala N. Rege · pp. 111–117Research PaperSame type: Article
• Article · VOLUME 10, ISSUE 4A Comparative Study of Intrathecal Isobaric 0.5% Bupivacaine and Intrathecal Isobaric 0.75% Ropivacaine in Elective Lower Segment Cesarean SectionAkshay Kishore Gadre, Kasturi Hossain Bandyopadhyay, Chumki Dutta, Tulsi Nag · pp. 126–131Research PaperSame type: Article
• Article · VOLUME 10, ISSUE 4A Comparative Study between Sublingual Misoprostol (PGE1) versus Intracervical Dinoprostone Gel (PGE2) in the Induction of Labor:‑ A Prospective Observational StudyT.H. Deepika, H. Nagabushan, R. Manohar · pp. 132–137Research PaperSame type: Article