Management of aromatase inhibitor-associated bone loss in postmenopausal women with breast cancer: Practical guidance for prevention and treatment Full Text
Annals of Oncology, 04/05/2011
Clinical Article
Hadji P et al. – All patients initiating AIs need advice regarding exercise, calcium/vitamin D supplements, baseline BMD monitoring (when available), and bone-directed therapy if T-score ?2.0 and no risk factors should be managed based on BMD loss during years 1–2. Unsatisfactory compliance/decreasing BMD after 12–24 months on oral bisphosphonates should trigger a switch to i.v. bisphosphonate.
Methods- Systematic literature review identified recent advances in preventing/treating AIBL
- Individual agents assessed based on trial size, design, follow-up, and safety
- Fracture risk factors in patients with EBC remain unchanged
- Practical guidance for the management of aromatase inhibitor-associated bone loss
- The World Health Organization Fracture Risk Assessment Tool algorithm includes fracture risk factors plus BMD but does not adequately address AIBL effects
- Several antiresorptives can prevent/treat AIBL
- Concerns regarding compliance and long-term efficacy/safety remain
- Evidence is strongest for twice-yearly zoledronic acid (ZOL), and recent advances support additional anticancer benefits from ZOL
