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- Title
Management of bone health in postmenopausal women on aromatase inhibitors (AIs): a single health care system experience.
- Authors
Tremblay, Douglas; Patel, Vaibhav; Fifer, Kenneth M.; Caro, Jessica; Kolodka, Olivia; Mandelli, John; Shapiro, Charles L.
- Abstract
<bold>Introduction: </bold>Aromatase inhibitors (AIs) are the preferred therapy for postmenopausal women with early-stage estrogen receptor-positive breast cancers. However, their use causes bone loss and increased risks of osteoporosis and fractures.<bold>Methods: </bold>This is a retrospective review of all postmenopausal women with breast cancer diagnosed and treated with AI between 2010 and 2015. Of the 564 women identified, 319 were eligible.<bold>Results: </bold>The median age at AI initiation was 65 years (range 51-85 years), and the median duration of AI therapy was 28 months (1-72 months). The median number of DEXA scans per woman was 1 (0-4), performed at a median frequency of 24 months (1-48 months). Recommendations for calcium and vitamin D were in 66 and 59% of women, respectively. There were 52 (16%) women who received antiresorptive treatments with bisphosphonates (69%), denosumab (25%), or both drugs (6%). Based on guideline recommendations from six societies, starting antiresorptive treatment was unnecessary in 15-54% of women.<bold>Conclusions: </bold>In this single health system experience, women start antiresorptive drugs that are unnecessary in 15-52%. These results highlight the nonuniformity in guideline recommendations, and this has implications for quality of care, cost-effectiveness, and value-of-care analyses for preventing fractures.
- Subjects
POSTMENOPAUSE; BREAST cancer diagnosis; AROMATASE inhibitors; BREAST cancer patients; BREAST cancer vaccines; THERAPEUTICS; PHYSIOLOGY; DENOSUMAB
- Publication
Supportive Care in Cancer, 2018, Vol 26, Issue 1, p197
- ISSN
0941-4355
- Publication type
journal article
- DOI
10.1007/s00520-017-3834-1