Titration of dosage for the protective effect of zoledronic acid on bone loss in patients submitted to androgen deprivation therapy due to prostate cancer: a prospective open-label study

Urologia Internationalis
Paulo RodriguesFlavio O Hering

Abstract

Bisphosphonates were incorporated as agents for the long-term effect of androgen deprivation therapy (ADT) but no comparative study was established for the optimal schedule for bone preservation. Ninety-five consecutive prostate cancer patients submitted to radical retropubic prostatectomy were recruited. At rising PSA they were prospectively enrolled in nonrandomized fashion and grouped to receive no treatment (21 - control group), and monthly (17), bi-monthly (15), tri-monthly (19) or semestral (15) 4 mg zoledronic acid infusions. The patients were followed to a minimum of 30 months after receiving ADT by LHRH agonists. Bone mineral density (BMD) was measured every 6 months in all 5 studied groups in order to compare the effect of each regimen to nontreatment. Tukey-Kramer and Scheffe's tests were used. The control group showed an impressive BMD loss throughout the study period. The 4 groups treated with zoledronic acid infusions showed increased BMD in the lumbar area on periodical densitometry and no statistical differences could be established among the 4 studied schedules. Different individual patterns of decreasing (control) or increasing (treated) BMD could be seen along the study as measured by bone densitometry. Zoled...Continue Reading

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