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Aromatase inhibitors attenuate the effect of alendronate in women with breast cancer

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Journal of Bone and Mineral Metabolism Aims and scope Submit manuscript

Abstract

Introduction

Aromatase inhibitors are known to accelerate bone loss in patients with breast cancer. However, how much AIs affect the efficacy of antiresorptive agents has not been studied. The study aimed to compare the effect of alendronate on bone mineral density (BMD) between patients with and without AI treatment.

Materials and methods

In this retrospective study, 90 postmenopausal women with early breast cancer who were being treated with both AI and alendronate 70 mg weekly (ALN + AI), and 90 age- and body mass index (BMI)-matched patients who were only taking alendronate (ALN-only) were analyzed. BMD and bone turnover markers (BTMs) were assessed at the baseline and 12 months.

Results

The mean age was 63 years. At baseline, the ALN-only group had lower lumbar spine (LS), femur neck (FN), and total hip (TH) BMD than ALN + AI group. After 1-year of alendronate treatment, the LS and FN BMD were improved more in the ALN-only group than those in the ALN + AI group after adjustments for age, BMI, baseline BMD, diabetes, hypertension, renal function, and previous fracture history [LS BMD: 6.2% (3.1%; 9.2%) in ALN-only, 3.5% (−0.5%; 6.5%) in ALN + AI, p = 0.001; FN BMD: 2.5% (0.3%; 5.7%) in ALN-only, 0.9% (− 1.8%; 3.6%) in ALD + AI, p = 0.032]. BTMs were significantly decreased in both groups, but the changes between groups were similar.

Conclusion

The effect of alendronate on the LS and FN BMD was attenuated in postmenopausal women who were taking AI compared to those who were not on AI.

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Authors and Affiliations

  1. Department of Internal Medicine, Seoul National University College of Medicine, 101 Dae-hak ro, Jongno gu, Seoul, 03080, Republic of Korea

    Sung Hye Kong, Jung Hee Kim, Sang Wan Kim & Chan Soo Shin

  2. Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea

    Sang Wan Kim

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  1. Sung Hye Kong
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  2. Jung Hee Kim
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by SHK. The first draft of the manuscript was written by SHK, and all authors commented on the manuscript. All authors read and approved the final manuscript.

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Correspondence to Chan Soo Shin.

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Kong, S.H., Kim, J.H., Kim, S.W. et al. Aromatase inhibitors attenuate the effect of alendronate in women with breast cancer. J Bone Miner Metab 38, 730–736 (2020). https://doi.org/10.1007/s00774-020-01111-3

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  • DOI: https://doi.org/10.1007/s00774-020-01111-3

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