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Casado E, Borque-Fernando A, Caamaño M, et al. Multidisciplinary Consensus on the Prevention and Treatment of Osteoporosis and Fragility Fractures in Patients with Prostate Cancer Receiving Androgen-Deprivation Therapy. World J Mens Health. 2022;40(1):74-86doi: 10.5534/wjmh.210061.
Casado, E., Borque-Fernando, A., Caamaño, M., Graña, J., Muñoz-Rodríguez, J., & Morote, J. (2022). Multidisciplinary Consensus on the Prevention and Treatment of Osteoporosis and Fragility Fractures in Patients with Prostate Cancer Receiving Androgen-Deprivation Therapy. The world journal of men's health, 40(1), 74-86. https://doi.org/10.5534/wjmh.210061
Casado, Enrique, et al. "Multidisciplinary Consensus on the Prevention and Treatment of Osteoporosis and Fragility Fractures in Patients with Prostate Cancer Receiving Androgen-Deprivation Therapy." The world journal of men's health vol. 40,1 (2022): 74-86. doi: https://doi.org/10.5534/wjmh.210061
Casado E, Borque-Fernando A, Caamaño M, Graña J, Muñoz-Rodríguez J, Morote J. Multidisciplinary Consensus on the Prevention and Treatment of Osteoporosis and Fragility Fractures in Patients with Prostate Cancer Receiving Androgen-Deprivation Therapy. World J Mens Health. 2022 Jan;40(1):74-86. doi: 10.5534/wjmh.210061. PMID: 34983087.
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World J Mens Health. 2022 Jan;40(1):74-86. doi: 10.5534/wjmh.210061.

Multidisciplinary Consensus on the Prevention and Treatment of Osteoporosis and Fragility Fractures in Patients with Prostate Cancer Receiving Androgen-Deprivation Therapy.

The world journal of men's health

Enrique Casado, Angel Borque-Fernando, Manuel Caamaño, Jenaro Graña, Jesús Muñoz-Rodríguez, Juan Morote

Affiliations

  1. Department of Rheumatology, University Hospital Parc Taulí, I3PT Research Institute (UAB), Sabadell, Barcelona, Spain. [email protected].
  2. Department of Urology, University Hospital Miguel Servet, Instituto de Investigación Sanitaria-Aragón, Zaragoza, Spain.
  3. Department of Rheumatology, University Clinical Hospital of Santiago de Compostela, A Coruña, Spain.
  4. Department of Rheumatology, A Coruña University Clinical Hospital, A Coruña, Spain.
  5. Department of Urology, University Hospital Parc Taulí, Sabadell, Barcelona, Spain.
  6. Department of Urology, Vall d'Hebron Hospital, Barcelona, Spain.
  7. Department of Surgery, Universitat Autònoma de Barcelona, Barcelona, Spain.

PMID: 34983087 DOI: 10.5534/wjmh.210061

Abstract

Patients with prostate cancer (PCa) on androgen-deprivation therapy (ADT) are at high risk of osteoporosis and fragility fractures. We aimed to provide some practical insights into the delivery of optimal bone health care for PCa patients, particularly those on ADT. An interdisciplinary group of experts, including urologists and rheumatologists developed recommendations based on their expertise, current evidence and guidelines. The multidisciplinary group's main recommendations are: fragility fracture risk should be assessed in all PCa patient, especially, in those under ADT. FRAX® tool may be incorporated into clinical practice to identify patients at high risk of fracture. Bone mineral density (BMD) should be measured routinely by dual energy X-ray absorptiometry in all patients scheduled for or on ADT. Thoracic and lumbar spine X-ray may be performed at the initial evaluation of patients with the diagnosis of osteoporosis and in case of suspected clinical vertebral fracture. Basic laboratory tests are recommended to exclude secondary osteoporosis. Treatment with bisphosphonates or denosumab should be considered in patients on ADT with fragility fracture, osteoporosis (BMD T-score ≤-2.5), or high risk of fracture according to FRAX®. Referral to a bone metabolism specialist should be contemplated in some cases. The recommendations provided in this document, tailored for clinicians treating PCa patients, may be of help to identify and treat patients at high risk of fracture.

Copyright © 2022 Korean Society for Sexual Medicine and Andrology.

Keywords: Androgen antagonists; Denosumab; Diphosphonates; Osteoporosis; Prostatic neoplasms

Conflict of interest statement

Casado E has received consulting fees or speaker remuneration from Eli Lilly, Amgen, UCB, Rubió, Theramex, Gebro, Italfármaco, Gedeon-Richter, STADA, Bayer, and GP-Pharma.

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