A single annual treatment with zoledronic acid appears to be sufficient to prevent bone loss in men rendered hypogonadal by treatment for prostate cancer, according to a report in the Journal of Clinical Oncology.

Osteoporosis is an important complication of gonadotropin-releasing hormone (GnRH) agonist treatment in men with prostate cancer, the authors point out, and quarterly treatment with zoledronic acid has previously been shown to increase bone mineral density (BMD) in such men.

Dr. Matthew R. Smith from Massachusetts General Hospital, Boston, Massachusetts and associates evaluated the efficacy of annual zoledronic acid in 40 men receiving GnRH agonists for nonmetastatic prostate cancer.

Men treated with zoledronic acid, 4 mg IV on one day, had increases of 4.0 per cent in lumbar spine BMD, 0.7 per cent in total hip BMD, and 1.7 per cent in trochanter BMD after 12 months, the researchers report. In the placebo group, BMD decreased 0.8 to 3.1 per cent depending on the site.

Treatment with zoledronic acid was associated with decreases in biochemical markers of bone turnover (N-telopeptide and bone-specific alkaline phosphatase), the results indicate, whereas both N-telopeptide and bone-specific alkaline phosphatase increased in the placebo group.

Neither treatment group experienced any serious adverse events, the researchers say.

"Annual zoledronic acid may represent a convenient and effective strategy to prevent osteoporosis in hypogonadal men," they conclude.


J Clin Oncol 2007;25:1038-1042.

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