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Anastrozole accelerates bone loss
Monday, 29 November 1999 19:00 | 
| Radiology News - Radiology Articles |
Progressive bone loss occurs over five years of treatment with anastrozole, but this effect needs to be weighed against the benefits of this aromatase inhibitor compared with tamoxifen.
"Progressive bone loss occurs over five years of treatment with anastrozole, but this effect needs to be weighed against the benefits of this aromatase inhibitor compared with tamoxifen.
Adjuvant anastrozole is more effective and better tolerated than tamoxifen in breast cancer patients, Dr. Richard Eastell, of Northern General Hospital, Sheffield, UK, and colleagues note. "However, anastrozole reduces circulating estrogen, and low estradiol levels are associated with decreased bone mineral density (BMD) and increased fracture risk."
To better understand the effects of long-term aromatase inhibitor therapy on BMD, the researchers examined BMD changes in 108 postmenopausal women with invasive primary breast cancer receiving anastrozole (n = 57) or tamoxifen (n = 51) as adjuvant therapy for five years.
The main outcome was the change in lumbar spine and total hip BMD from baseline. Measurements were made at baseline and after one, two, and five years by dual-energy X-ray absorptiometry. The findings appear in the March issue of the Journal of Clinical Oncology.
Anastrozole-treated women experienced a decrease in median BMD from baseline to five years in the lumbar spine (-6.08 per cent) and total hip (-7.24). Tamoxifen-treated women had an increase in median BMD over the five-year period in lumbar spine (+2.77 per cent) and total hip (+0.74 per cent).
However, women with normal BMD at baseline did not become osteoporotic at five years.
"Women who start aromatase inhibitors for breast cancer should have their bone density checked," Dr. Eastell said in an interview with Reuters Health. "If it is normal, there is no need for concern; if it shows osteoporosis then treatment for osteoporosis should be started," he advised.
"If it is in between normal and osteoporosis (osteopenia), then it would be important to have another measurement of bone density after two years on treatment."
"We now plan to measure bone density two years after stopping anastrozole to see whether the effect is reversible," Dr. Eastell noted."
Adjuvant anastrozole is more effective and better tolerated than tamoxifen in breast cancer patients, Dr. Richard Eastell, of Northern General Hospital, Sheffield, UK, and colleagues note. "However, anastrozole reduces circulating estrogen, and low estradiol levels are associated with decreased bone mineral density (BMD) and increased fracture risk."
To better understand the effects of long-term aromatase inhibitor therapy on BMD, the researchers examined BMD changes in 108 postmenopausal women with invasive primary breast cancer receiving anastrozole (n = 57) or tamoxifen (n = 51) as adjuvant therapy for five years.
The main outcome was the change in lumbar spine and total hip BMD from baseline. Measurements were made at baseline and after one, two, and five years by dual-energy X-ray absorptiometry. The findings appear in the March issue of the Journal of Clinical Oncology.
Anastrozole-treated women experienced a decrease in median BMD from baseline to five years in the lumbar spine (-6.08 per cent) and total hip (-7.24). Tamoxifen-treated women had an increase in median BMD over the five-year period in lumbar spine (+2.77 per cent) and total hip (+0.74 per cent).
However, women with normal BMD at baseline did not become osteoporotic at five years.
"Women who start aromatase inhibitors for breast cancer should have their bone density checked," Dr. Eastell said in an interview with Reuters Health. "If it is normal, there is no need for concern; if it shows osteoporosis then treatment for osteoporosis should be started," he advised.
"If it is in between normal and osteoporosis (osteopenia), then it would be important to have another measurement of bone density after two years on treatment."
"We now plan to measure bone density two years after stopping anastrozole to see whether the effect is reversible," Dr. Eastell noted."
