Oral bisphosphonate may stem bone loss in men with prostate cancer

Alendronate (Fosamax), a bisphosphonate commonly used to treat osteoporosis in postmenopausal women, has been shown to halt and reverse bone loss associated with androgen deprivation therapy in men with prostate cancer.

"The rate of bone loss from androgen deprivation is greater than in normal aging," said Susan Greenspan, MD, of the University of Pittsburgh Medical Center. "Men on androgen deprivation therapy lose bone at a similar rate to [that of] newly menopausal women."

One-year results from a 2-year randomized, double-blind, placebo-controlled trial with 112 men were reported by Dr. Greenspan and colleagues on Monday. At baseline, only 9% of men had normal bone mass, 52% had low bone mass, and 39% had osteoporosis. After 1 year, men in the alendronate arm gained 4.9% bone mass at the spine and 2.1% at the hip. Men in the placebo arm continued to deteriorate, with losses of bone mass from baseline of 1.3% at the spine and 0.7% at the hip.

No significant difference was demonstrated between the two groups in terms of adverse events. Typical but uncommon complaints associated with alendronate therapy included heartburn or other gastrointestinal upset, difficulty in swallowing, or joint pain and stiffness, Dr. Greenspan said.