Early Denosumab for the prevention of osteoporotic fractures in breast cancer women undergoing aromatase inhibitors: A case-control retrospective study
Affiliations: [a] Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy | [b] Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Catanzaro, Italy | [c] Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, Mantova, Italy | [d] Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy | [e] Department of Economics and Statistics, University of Palermo, Palermo, Italy | [f] Department of Medical and Surgical Sciences and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
Correspondence:
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Corresponding author: Alessandro de Sire, Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Viale Europa, 88100 Catanzaro, Italy. Tel.: +39 961369768; E-mail: alessandro.desire@unicz.it.
Note: [1] These authors equally contribute as first authors.
Abstract: BACKGROUND: Aromatase inhibitors (AIs) might have a detrimental impact on bone health in breast cancer (BC) women. Denosumab has been shown to reduce the risk of fractures, but the appropriate time for starting is yet to be clearly defined. OBJECTIVE: To evaluate the effects of early treatment with Denosumab (⩽ 12 months after starting AIs) compared to a delayed treatment in BC women. METHODS: In this retrospective case-control study, we included medical records of BC post-menopausal women, treated with AIs therapy; they were divided as: study group (starting Denosumab ⩽ 12 months after AIs) and control group (> 12 months). At the baseline (T0) and at 18 months (T1), we evaluated the lumbar spine (LS) Tscore and femoral neck (FN) Tscore. Furthermore, at T1 we assessed the incident fragility fractures. RESULTS: Fifty-nine BC survivors (mean age: 61.5 ± 11.5 years) were included: 28 with Early Denosumab and 31 with Late Denosumab. At T1, the study group did not show any incident hip or vertebral fragility fracture, whereas the Late Denosumab group showed 2 incident hip fractures (6.5%) and 4 (12.9%) vertebral fragility fractures. Early Denosumab showed a significant positive effect on both LS (p= 0.044) and FN (p= 0.024) Tscore variations. CONCLUSION: Taken together, our findings suggest that an early start of Denosumab might be considered for the osteoporosis management in BC women undergoing AIs.
Keywords: Osteoporosis, risk of fractures, breast cancer, denosumab, bone health
