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Taguchi T, Matsushima H, Kodama S, Okubo N, Ito T, Ludwikowska M, Fukumoto S, Matsumoto T. Osteoporotic fracture risk in women with breast cancer treated with aromatase inhibitors: a health insurance claims database study in Japan. Expert Opin Pharmacother 2024; 25:325-334. [PMID: 38588537 DOI: 10.1080/14656566.2024.2340712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 03/01/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Hormone therapy with aromatase inhibitors (AIs) for estrogen receptor-dependent breast cancer may expose patients to an increased osteoporosis risk. This study was performed to estimate fracture risk in women with breast cancer to whom AIs were prescribed in Japan. METHODS This retrospective study used data from the Japanese Medical Data Vision database. Women with breast cancer prescribed AIs over a 12-month period were identified and matched to women not prescribed AIs using a propensity score. Fracture rates were estimated by a cumulative incidence function and compared using a cause-specific Cox hazard model. The proportion of women undergoing bone density tests was retrieved. RESULTS For all fractures sites combined, cumulative fracture incidence at 10 years was 0.19 [95%CI: 0.16-0.22] in women prescribed AIs and 0.18 [95%CI: 0.15-0.21] without AIs. AI prescription was not associated with any changes in risk (adjusted hazard ratio: 1.08 [95%CI: 0.99-1.17] p = 0.08). Women prescribed AI more frequently underwent bone density testing (31.9% [95% CI: 31.2%; 32.6%] versus 2.2% [95% CI: 2.0%; 2.4%]). CONCLUSIONS The anticipated association between AI exposure and osteoporotic fracture risk in Japanese women with breast cancer was not seen clearly.
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Affiliation(s)
- Tetsuya Taguchi
- Division of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Sho Kodama
- Primary Medical Science Department, Medical Affairs Division, Japan Business Unit, Daiichi Sankyo Co., Ltd ., Tokyo, Japan
| | - Naoki Okubo
- Data Intelligence Department, Global DX, Daiichi Sankyo Co., Ltd., Tokyo, Japan
| | - Tetsuo Ito
- Primary Medical Science Department, Medical Affairs Division, Japan Business Unit, Daiichi Sankyo Co., Ltd ., Tokyo, Japan
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Xu J, Cao B, Li C, Li G. The recent progress of endocrine therapy-induced osteoporosis in estrogen-positive breast cancer therapy. Front Oncol 2023; 13:1218206. [PMID: 37483519 PMCID: PMC10361726 DOI: 10.3389/fonc.2023.1218206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 06/23/2023] [Indexed: 07/25/2023] Open
Abstract
Breast cancer is a significant global health concern, and the discovery of endocrine therapy has played a crucial role in the treatment of estrogen-positive breast cancer. However, these therapies are often associated with osteoporosis-related adverse events, which increase the risk of fractures in breast cancer patients and can result in limited mobility and reduced quality of life. Previous studies have shown that osteoporosis is essential side effects of the breast cancer therapy, although the exact mechanisms remain mostly unclear. Current clinical treatments, such as bisphosphonates, cause side effects and may impact the therapeutic response to endocrine drugs. In this review, we explore the likelihood of endocrine therapy-induced osteoporosis in estrogen-positive breast cancer therapy and discuss the involved mechanisms as well as the therapeutic potential of drugs and drug combination strategies.
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Affiliation(s)
| | | | - Chunyu Li
- *Correspondence: Chunyu Li, ; Guohui Li,
| | - Guohui Li
- *Correspondence: Chunyu Li, ; Guohui Li,
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Mazziotti G, Pedersini R, Vena W, Cosentini D, Carrone F, Pigni S, Simoncini EL, Torrisi R, Zambelli A, Farina D, Balzarini L, Lania AG, Berruti A. Real-World Effectiveness of Denosumab and Bisphosphonates on Risk of Vertebral Fractures in Women with Breast Cancer Undergoing Treatment with Aromatase Inhibitors. Calcif Tissue Int 2022; 111:466-474. [PMID: 35902384 DOI: 10.1007/s00223-022-01011-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/09/2022] [Indexed: 12/11/2022]
Abstract
Bone-active drugs are recommended to protect the skeleton from detrimental actions of aromatase inhibitors (AIs). However, most of literature data are focused on bone mineral density (BMD), whereas data on fractures are scant. The aim of this prospective study was to investigate the real-life effectiveness of denosumab, oral bisphosphonates (BPs) and intravenous zoledronate on risk of vertebral fractures (VFs) induced by AIs. 567 consecutive women (median age 62 years, range 28-83) with early breast cancer undergoing treatment with AIs were evaluated for morphometric VFs and BMD at baseline and after 18-24 months of follow-up. After enrollment, 268 women (47.3%) started denosumab 60 mg subcutaneously every 6 months, 115 (20.3%) BPs (59 with oral BPs and, 56 with intravenous zoledronate 5 mg/12 months), whereas 184 women (32.5%) were not treated with bone-active drugs for several reasons. During follow-up, 54 women (9.5%) developed incident VFs in association with age of subjects (P < 0.001), baseline FRAX scores for major fractures (P < 0.001) and hip fractures (P = 0.003), pre-existing VFs (P < 0.001), change in BMD at lumbar spine (P = 0.015), femoral neck (P = 0.003) and total hip (P < 0.001). Risk of VFs was higher in subjects who were untreated as compared to those treated with bone-active drugs (32/184 vs. 22/383; P < 0.001). Specifically, fracture risk was significantly decreased by denosumab [odds ratio (OR) 0.22; P < 0.001] and zoledronate (OR 0.27; P = 0.035), but not by oral BPs (P = 0.317). These data suggest that in real-world clinical practice, denosumab and zoledronate can reduce AI-related risk of VFs after only 24 months of treatment.
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Affiliation(s)
- Gherardo Mazziotti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy
- Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
| | - Rebecca Pedersini
- Medical Oncology Unit, ASST Spedali Civili Di Brescia, Brescia, Italy
| | - Walter Vena
- Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
- Medical Oncology Unit, ASST Spedali Civili Di Brescia, Brescia, Italy
- Endocrinology and Diabetology Center, Humanitas Gavazzeni-Castelli, Bergamo, Italy
| | - Deborah Cosentini
- Medical Oncology Unit, ASST Spedali Civili Di Brescia, Brescia, Italy
| | - Flaminia Carrone
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy
- Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
| | - Stella Pigni
- Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
| | - Edda L Simoncini
- Medical Oncology Unit, ASST Spedali Civili Di Brescia, Brescia, Italy
| | - Rosalba Torrisi
- Cancer Center IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
| | - Alberto Zambelli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy
- Cancer Center IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
| | - Davide Farina
- Radiology Unit, ASST Spedali Civili Di Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Luca Balzarini
- Department of Radiology, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
| | - Andrea G Lania
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy.
- Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy.
| | - Alfredo Berruti
- Medical Oncology Unit, ASST Spedali Civili Di Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
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Li Y, Li L, Li X, Luo B, Ye Q, Wang H, Yang L, Zhu X, Han L, Zhang R, Tian H, Wang P. A mechanistic review of chinese medicine polyphenols on bone formation and resorption. Front Pharmacol 2022; 13:1017538. [PMID: 36313339 PMCID: PMC9597080 DOI: 10.3389/fphar.2022.1017538] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/03/2022] [Indexed: 11/17/2022] Open
Abstract
Bone reconstruction includes a steady state system of bone formation and bone absorption. This tight coupling requires subtle coordination between osteoblasts and osteoclasts. If this balance is broken, it will lead to bone mass loss, bone density reduction, and bone metabolic diseases, such as osteoporosis. Polyphenols in Chinese herbal medicines are active ingredients in plant extracts with high safety and few side effects, and they can play a role in affecting bone formation and bone resorption. Some of these have estrogen-like effects and can better target bone health in postmenopausal women. The purpose of this review is to provide comprehensive information on the mechanisms underlying the relationship between traditional Chinese medicine polyphenols and bone formation or bone resorption.
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Affiliation(s)
- Yan Li
- College of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Lingyu Li
- Cancer Research Institute, Jinan University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Jinan University, Guangzhou, China
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Xiaoyun Li
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Bingjie Luo
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Qianyun Ye
- College of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Haoyu Wang
- College of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Li Yang
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Jinan University, Guangzhou, China
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Xiaofeng Zhu
- College of Traditional Chinese Medicine, Jinan University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Jinan University, Guangzhou, China
| | - Li Han
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Jinan University, Guangzhou, China
- First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Ronghua Zhang
- Cancer Research Institute, Jinan University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Jinan University, Guangzhou, China
- College of Pharmacy, Jinan University, Guangzhou, China
- *Correspondence: Ronghua Zhang, ; Huaqin Tian, ; Panpan Wang,
| | - Huaqin Tian
- Foshan Hospital of Traditional Chinese Medicine, Foshan, China
- *Correspondence: Ronghua Zhang, ; Huaqin Tian, ; Panpan Wang,
| | - Panpan Wang
- Cancer Research Institute, Jinan University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Jinan University, Guangzhou, China
- First Affiliated Hospital of Jinan University, Guangzhou, China
- *Correspondence: Ronghua Zhang, ; Huaqin Tian, ; Panpan Wang,
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Bassatne A, Bou Khalil A, Chakhtoura M, Arabi A, Van Poznak C, El-Hajj Fuleihan G. Effect of antiresorptive therapy on aromatase inhibitor induced bone loss in postmenopausal women with early-stage breast cancer: A systematic review and meta-analysis of randomized controlled trials. Metabolism 2022; 128:154962. [PMID: 34958816 DOI: 10.1016/j.metabol.2021.154962] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/30/2021] [Accepted: 12/14/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Aromatase inhibitors (AIs) are routinely used to treat postmenopausal women with early-stage breast cancer. Although AIs improve breast cancer outcomes, they increase the risk of osteoporosis and fractures. This systematic review and meta-analysis assesses the effect of antiresorptive drugs on AI induced bone loss in postmenopausal women with non-metastatic breast cancer. METHODS We searched four databases until November 4th 2020. We included Randomized controlled trials (RCTs) of antiresorptive drugs in postmenopausal women with breast cancer treated with AI. Two authors screened studies, extracted data and assessed the risk of bias independently and in duplicate. RESULTS We identified 14 RCTs: 7 on zoledronic acid, 6 on oral bisphosphonates and 1 on denosumab. The mean difference in bone mineral density (BMD) was 5% at the lumbar spine and 4% at the total hip, at 12 months, favoring zoledronic acid compared to control. The certainty of the evidence was low for lumbar spine and moderate for total hip BMD. Similarly, the mean difference was 3% at the lumbar spine and 2% at the total hip, favoring oral bisphosphonates with moderate certainty. The mean difference was 6% at the lumbar spine, and 4% at the total hip BMD favoring denosumab compared to placebo. In addition, zoledronic acid resulted in a mean difference in bone turnover marker levels of -35-41%, and the relarive risk for morphometric vertebral fractures was 0.7 [0.3-1.4], compared to control. Denosumab reduced fracture incidence by 50% compared to placebo. CONCLUSION Evidence suggests a protective effect of antiresorptive drugs on BMD and bone turnover markers in postmenopausal women with non-metastatic breast cancer on AI. However, data on fracture risk reduction remains unclear.
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Affiliation(s)
- Aya Bassatne
- Calcium Metabolism and Osteoporosis Program, Division of Endocrinology and Metabolism, WHO Collaborating Center in Metabolic Bone Disorders, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Abir Bou Khalil
- Calcium Metabolism and Osteoporosis Program, Division of Endocrinology and Metabolism, WHO Collaborating Center in Metabolic Bone Disorders, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Marlene Chakhtoura
- Calcium Metabolism and Osteoporosis Program, Division of Endocrinology and Metabolism, WHO Collaborating Center in Metabolic Bone Disorders, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Asma Arabi
- Calcium Metabolism and Osteoporosis Program, Division of Endocrinology and Metabolism, WHO Collaborating Center in Metabolic Bone Disorders, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Ghada El-Hajj Fuleihan
- Calcium Metabolism and Osteoporosis Program, Division of Endocrinology and Metabolism, WHO Collaborating Center in Metabolic Bone Disorders, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
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Waqas K, Lima Ferreira J, Tsourdi E, Body JJ, Hadji P, Zillikens M. Updated guidance on the management of cancer treatment-induced bone loss (CTIBL) in pre- and postmenopausal women with early-stage breast cancer. J Bone Oncol 2021; 28:100355. [PMID: 33948427 PMCID: PMC8080519 DOI: 10.1016/j.jbo.2021.100355] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Adjuvant endocrine therapy induces bone loss and increases fracture risk in women with hormone-receptor positive, early-stage breast cancer (EBC). We aimed to update a previous position statement on the management of aromatase inhibitors (AIs) induced bone loss and now included premenopausal women. METHODS We conducted a systematic literature search of the medical databases from January 2017 to May 2020 and assessed 144 new studies. RESULTS Extended use of AIs beyond 5 years leads to persistent bone loss in breast cancer extended adjuvant trials and meta-analyses. In addition to bone mineral density (BMD), vertebral fracture assessment (VFA) and trabecular bone score (TBS) were shown to independently predict fracture risk in real life prospective studies. FRAX® tool does not seem to be reliable for assessing fracture risk in CTIBL. In premenopausal women, there is strong evidence that intravenous zoledronate prevents bone loss but weak conflicting evidence on reducing disease recurrence from independent randomised controlled trials (RCTs). In postmenopausal women, the strongest evidence for fracture prevention is for denosumab based on a well-powered RCT while there is strong evidence for bisphosphonates (BPs) to prevent and reduce CTIBL but no convincing data on fractures. Adjuvant denosumab has failed to show anticancer benefits in a large, well-designed RCT. DISCUSSION AND CONCLUSIONS Extended use of AIs and persistent bone loss from recent data reinforce the need to evaluate fracture risk in EBC women initiated on AIs. Fracture risk should be assessed with clinical risk factors and BMD along with VFA, but FRAX is not adapted to CTIBL. Anti-resorptive therapy should be considered in those with a BMD T-score < -2.0 SD or with ≥ 2 clinical risk factors including a BMD T-score < -1.0 SD. In premenopausal women, intravenous zoledronate is the only drug reported to prevent bone loss and may have additional anticancer benefits. In postmenopausal women, either denosumab or BPs can be prescribed for fracture prevention with pertinent attention to the rebound phenomenon after stopping denosumab. Adjuvant BPs, in contrast to denosumab, have shown high level evidence for reducing breast cancer recurrence in high-risk post-MP women which should be taken into account when choosing between these two.
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Affiliation(s)
- Komal Waqas
- Bone Centre, Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Joana Lima Ferreira
- Department of Endocrinology, Hospital Pedro Hispano, Matosinhos Local Health Unit, Matosinhos, Portugal
| | - Elena Tsourdi
- Department of Medicine III and 4. Center for Healthy Aging, Technische Universität Dresden Medical Center, Dresden, Germany
- Department of Medicine, CHU Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Jean-Jacques Body
- Department of Medicine, CHU Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Peyman Hadji
- Frankfurt Center of Bone Health, Goethestrasse 23, Frankfurt, Germany and Philipps-University of Marburg, Germany
| | - M.C. Zillikens
- Bone Centre, Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, the Netherlands
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Miyashita H, Satoi S, Kuno T, Cruz C, Malamud S, Kim SM. Bone modifying agents for bone loss in patients with aromatase inhibitor as adjuvant treatment for breast cancer; insights from a network meta-analysis. Breast Cancer Res Treat 2020; 181:279-289. [PMID: 32318956 DOI: 10.1007/s10549-020-05640-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 04/08/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE The data of head-to-head comparisons of the anti-fracture efficacy of bone modifying agents (BMAs) in patients with hormone receptor-positive breast cancer receiving aromatase inhibitor (AI) are not available. Therefore, we conducted a network meta-analysis to compare the efficacy of different BMAs in patients with breast cancer receiving adjuvant AI. METHODS We performed a network meta-analysis to compare the change of bone mineral densities (BMDs) and the risk of fracture in the selected studies using a random effect model. The primary outcomes are the change of BMD of lumbar spine (LS) and total hip (TH) from the baseline (ΔBMD, %) at 1 and 2 years and the risk of fracture. RESULTS We identified and included a total of 16 randomized controlled trials for this analysis. All BMAs included (risedronate, zoledronate, and denosumab) were associated with a significant increase in BMD of LS and TH at 1 and 2 years compared with no upfront treatment group. Among BMAs, zoledronate and denosumab use resulted in significantly higher BMD of LS and TH at 1 and 2 years compared with risedronate. The risk of fracture was significantly lower in the patients who received denosumab or risedronate compared with the patients without upfront treatment (Relative risk (RR) [95% CI] 0.51 [0.38-0.67] and 0.54 [0.35-0.83], respectively). CONCLUSION Among the bisphosphonates, zoledronate increased BMD the most, but risedronate, not zoledronate, use was associated with lower risk of fracture. Denosumab increased BMD not only of LS but also of the cortical-bone-rich hip, and showed a significant reduction of fracture risk.
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Affiliation(s)
- Hirotaka Miyashita
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY, USA. .,Mount Sinai Bone Program, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Sera Satoi
- Department of Medicine, Nippon Medical School Hospital, Tokyo, Japan
| | - Toshiki Kuno
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY, USA
| | - Christina Cruz
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY, USA
| | - Stephen Malamud
- Mount Sinai Beth Israel Comprehensive Cancer Center, New York, NY, USA
| | - Se-Min Kim
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY, USA. .,Mount Sinai Bone Program, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Pandey MK, Gupta SC, Karelia D, Gilhooley PJ, Shakibaei M, Aggarwal BB. Dietary nutraceuticals as backbone for bone health. Biotechnol Adv 2018; 36:1633-1648. [DOI: 10.1016/j.biotechadv.2018.03.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 03/13/2018] [Accepted: 03/21/2018] [Indexed: 12/11/2022]
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Mohamed AAR, Ahmed MM, Gomaa M, Ebraheim LLM. Bone health consequence of adjuvant Anastrozole in monotherapy or associated with biochanin-A in ovariectomized rat model. Life Sci 2018; 212:159-167. [PMID: 30290186 DOI: 10.1016/j.lfs.2018.09.059] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 09/01/2018] [Accepted: 09/28/2018] [Indexed: 02/07/2023]
Abstract
AIMS We investigate the consequence of adjuvant anastrozole (ANA) in monotherapy or associated with biochanin A (BCA) in ovariectomized (OVX) rat model and the degree of developing bone loss in both conditions. MATERIALS AND METHODS Sixty female rats were assigned to six groups. Five groups were bilaterally OVX, and one was sham operated. The five groups were; ANA group (0.5 mg/kg b.wt orally), BCA (5 mg/kg b.wt intraperitoneally (I/P), co-treated group (BCA + ANA), two control groups receiving even distilled water orally or DMSO I/P for twenty weeks. Bone turnover biomarkers BALP, OC, PTH, TRAP and TNFα were determined in serum. Bone mineral content, histological and morphometric measurements on rat femurs were performed. BMD by X-ray technique on tibias of rats and CT analysis of lumbar vertebrae of all treated and sham groups were applied. KEY FINDINGS There was marked elevation in bone turnover biomarkers with high serum Ca and P content in the ANA-treated rats. Moreover marked elevation of TNFα, PTH, TC and TG, ANA caused severe changes in the BMD detected by X-ray in tibial bones and CT analysis of lumbar vertebrae of OVX rats. While I/P injection of BCA ameliorated the adverse bone health decrements caused by ANA. SIGNIFICANCE The study highlights the importance of the BCA supplementation in accordance with the ANA therapy in case of ovariectomized rat model of osteoporosis which is clinically presented in Postmenopausal women with breast cancer during which considerable risk of developing osteoporosis is predicted during treatment.
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Affiliation(s)
| | - Mona M Ahmed
- Dept. of Forensic Medicine and Toxicology, Zagazig University, Zagazig, Egypt
| | - Mohamed Gomaa
- Dept. of Surgery, Zagazig University, Zagazig, Egypt
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