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Prevention of aromatase inhibitor-induced bone loss with alendronate in postmenopausal women: the BATMAN trial

Lomax, Anna J., Yee Yap, Saw, White, Karen, Beith, Jane, Abdi, Ehtesham, Broad, Adam, Sewak, Sanjeev, Lee, Chooi, Sambrook, Philip, Pocock, Nicholas, Henry, Margaret J., Yeow, Elaine G. and Bell, Richard 2013, Prevention of aromatase inhibitor-induced bone loss with alendronate in postmenopausal women: the BATMAN trial, Journal of bone oncology, vol. 2, no. 4, pp. 145-153, doi: 10.1016/j.jbo.2013.08.001.

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Title Prevention of aromatase inhibitor-induced bone loss with alendronate in postmenopausal women: the BATMAN trial
Author(s) Lomax, Anna J.
Yee Yap, Saw
White, Karen
Beith, Jane
Abdi, Ehtesham
Broad, Adam
Sewak, Sanjeev
Lee, Chooi
Sambrook, Philip
Pocock, Nicholas
Henry, Margaret J.
Yeow, Elaine G.
Bell, Richard
Journal name Journal of bone oncology
Volume number 2
Issue number 4
Start page 145
End page 153
Total pages 9
Publisher Elsevier BV
Place of publication Amsterdam, The Netherlands
Publication date 2013
ISSN 2212-1374
Keyword(s) aromatase inhibitor
osteoporosis
bisphosphonates
bone mineral density
breast cancer
post menopausal
Summary Abstract:
Postmenopausal women on aromatase inhibitors (AI) are at risk of aromatase inhibitor-associated bone loss (AIBL) and fractures.

In 2005 Osteoporosis Australia proposed an algorithm for bisphosphonate intervention. Three hundred and three postmenopausal women with early breast cancer (EBC) were enrolled (osteoporotic, n=25; osteopaenic, n=146; normal bone mineral density (BMD), n=126). Weekly alendronate (70 mg) treatment efficacy as triggered by the algorithm in preventing bone loss was evaluated. All patients received anastrozole (1 mg daily), calcium and vitamin D.

Results:
All osteoporotic patients received alendronate at baseline. Eleven out of the 146 (7.5%) osteopaenic patients commenced alendronate within 18 months of participation and eleven commenced after. One hundred and twenty four out of the 146 (84.9%) osteopaenic patients and all 126 with normal baseline BMD did not trigger the algorithm.

At three years, lumbar spine mean BMD increased (15.6%, p<0.01) in the osteoporotic group. BMD in the osteopaenic group with early intervention significantly increased at three years (6.3%, p=0.02). No significant change was seen in the late intervention group. No change was observed in those with osteopaenia without alendronate.

There was a significant drop in lumbar spine (−5.4%) and hip (−4.5%) mean BMD, in the normal BMD group, none of whom received alendronate.

Fracture data will be presented.

Conclusion:
In postmenopausal women with endocrine-responsive EBC, BMD improved over time when a bisphosphonate is administered with anastrozole in osteoporotic patients using an osteoporosis schedule. Subjects with normal baseline BMD experienced the greatest BMD loss, although none became osteoporotic.
Language eng
DOI 10.1016/j.jbo.2013.08.001
Field of Research 111299 Oncology and Carcinogenesis not elsewhere classified
Socio Economic Objective 920102 Cancer and Related Disorders
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2013, Elsevier
Persistent URL http://hdl.handle.net/10536/DRO/DU:30057094

Document type: Journal Article
Collection: School of Medicine
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Created: Tue, 22 Oct 2013, 12:39:54 EST by Jane Moschetti

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