Degarelix tied to BMD decrease, bone turnover marker increase in prostate cancer patients

Treatment with degarelix results in a substantial reduction in bone mineral density (BMD) and an increase in bone turnover markers, reports a study.

Furthermore, appendicular mass index (ALMI) shows potential as a predictor of bone loss in patients with prostate cancer receiving androgen deprivation therapy. ALMI changes during therapy correlate with bone turnover derangement favouring bone quality alterations.

This study was conducted to describe the changes in BMD and bone turnover markers following degarelix administration in prostate cancer patients without bone metastases, as well as explore the predictive role of body composition on treatment-induced bone loss.

The researchers assessed BMD and body composition (ie, lean body mass, fat body mass, and ALMI) using dual X-ray absorptiometry on study entry and after 12 months of treatment. They also assessed alkaline phosphate (ALP) and C-terminal telopeptide of type I collagen (CTX) at baseline and at 6 and 12 months.

Twenty-nine patients participated in this study. At 12 months, degarelix administration resulted in a significant decrease in BMD (2.4 percent reduction at lumbar spine from baseline). Serum CTX and ALP significantly increased (median increase from baseline, 99 percent and 19.3 percent, respectively).

ALMI was inversely associated with CTX, but not ALP, both at baseline (Pearson r, ‒0.62; p<0.0001) and 12 months (Pearson r, ‒0.41; p=0.032). In addition, ALMI changes showed a significant inverse association with CTX at 12 months (Pearson r, ‒0.43; p=0.019) and a direct correlation with ALP (Pearson r, 0.44; p=0.016) during degarelix treatment.

“As patients are now living with prostate cancer for longer, the long-term impact of hormonal treatment on bone health is an increasingly debated subject,” the researchers said.