Herbert James1, Ilija Aleksic2, Marc Nicolas Bienz3, Christopher Pieczonka1, Peter Iannotta1, David Albala1, Neil Mariados1, Vladimir Mouraviev4, Fred Saad5. 1. Associated Medical Professionals of New York, Syracuse, NY. 2. SUNY Upstate Medical University, Syracuse, NY. 3. Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada. 4. Associated Medical Professionals of New York, Syracuse, NY. Electronic address: vmouraviev@ampofny.com. 5. Division of Urology, University of Montreal Hospital Center, Montreal, Quebec, Canada.
Abstract
OBJECTIVE: To estimate the risk of fracture (Fracture Risk Assessment Tool [FRAX] algorithm) because of the development of osteoporosis in prostate cancer patients undergoing androgen deprivation therapy (ADT) for patients who would otherwise not have been identified for treatment by the T score. METHODS: This study includes men undergoing ADT for prostate cancer at our urology group. Clinical data were collected via chart review. Subjects were evaluated for fracture risk using country specific (for the United States of America) World Health Organization's FRAX. The FRAX calculations were then compared to fracture risk as determined by T score, for a subset of our cohort that received dual-energy X-ray absorptiometry. RESULTS: Our cohort consisted of 613 patients on ADT, 94 of which had a dual-energy X-ray absorptiometry scan. The FRAX algorithm identified 61.6% patients requiring therapy without bone mass density (BMD), 46.8% with BMD, and 19.14% with T score alone. In addition, positive correlation was found between FRAX with and without BMD as well as T score and FRAX with BMD and without BMD. CONCLUSION: Our data indicate that many patients who were not found at significant risk for fracture with T score were in fact found to be at risk with the FRAX calculation. The largest proportion of patients was found to be at risk through the FRAX calculation without BMD, followed by FRAX with BMD, followed by T score alone. The utility of FRAX is beneficial in identifying patients that may benefit from effective bone-tropic treatment modalities.
OBJECTIVE: To estimate the risk of fracture (Fracture Risk Assessment Tool [FRAX] algorithm) because of the development of osteoporosis in prostate cancerpatients undergoing androgen deprivation therapy (ADT) for patients who would otherwise not have been identified for treatment by the T score. METHODS: This study includes men undergoing ADT for prostate cancer at our urology group. Clinical data were collected via chart review. Subjects were evaluated for fracture risk using country specific (for the United States of America) World Health Organization's FRAX. The FRAX calculations were then compared to fracture risk as determined by T score, for a subset of our cohort that received dual-energy X-ray absorptiometry. RESULTS: Our cohort consisted of 613 patients on ADT, 94 of which had a dual-energy X-ray absorptiometry scan. The FRAX algorithm identified 61.6% patients requiring therapy without bone mass density (BMD), 46.8% with BMD, and 19.14% with T score alone. In addition, positive correlation was found between FRAX with and without BMD as well as T score and FRAX with BMD and without BMD. CONCLUSION: Our data indicate that many patients who were not found at significant risk for fracture with T score were in fact found to be at risk with the FRAX calculation. The largest proportion of patients was found to be at risk through the FRAX calculation without BMD, followed by FRAX with BMD, followed by T score alone. The utility of FRAX is beneficial in identifying patients that may benefit from effective bone-tropic treatment modalities.
Authors: Marc A Stadelmann; Denis E Schenk; Ghislain Maquer; Christopher Lenherr; Florian M Buck; Dieter D Bosshardt; Sven Hoppe; Nicolas Theumann; Ron N Alkalay; Philippe K Zysset Journal: Bone Date: 2020-08-20 Impact factor: 4.626