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Efficacy of Antiresorptive Drugs on Bone Mineral Density in Post-Menopausal Women With Early Breast Cancer Receiving Adjuvant Aromatase Inhibitors: A Systematic Review of Randomized Controlled Trials

BACKGROUND: Cancer treatment-induced bone loss (CTIBL) is a frequent complication of breast cancer therapies affecting both disability and health-related quality of life (HRQoL). To date, there is still a lack of consensus about the most effective approach that would improve bone health and HRQoL. T...

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Autores principales: de Sire, Alessandro, Lippi, Lorenzo, Venetis, Konstantinos, Morganti, Stefania, Sajjadi, Elham, Curci, Claudio, Ammendolia, Antonio, Criscitiello, Carmen, Fusco, Nicola, Invernizzi, Marco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8814453/
https://www.ncbi.nlm.nih.gov/pubmed/35127539
http://dx.doi.org/10.3389/fonc.2021.829875
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author de Sire, Alessandro
Lippi, Lorenzo
Venetis, Konstantinos
Morganti, Stefania
Sajjadi, Elham
Curci, Claudio
Ammendolia, Antonio
Criscitiello, Carmen
Fusco, Nicola
Invernizzi, Marco
author_facet de Sire, Alessandro
Lippi, Lorenzo
Venetis, Konstantinos
Morganti, Stefania
Sajjadi, Elham
Curci, Claudio
Ammendolia, Antonio
Criscitiello, Carmen
Fusco, Nicola
Invernizzi, Marco
author_sort de Sire, Alessandro
collection PubMed
description BACKGROUND: Cancer treatment-induced bone loss (CTIBL) is a frequent complication of breast cancer therapies affecting both disability and health-related quality of life (HRQoL). To date, there is still a lack of consensus about the most effective approach that would improve bone health and HRQoL. Therefore, the aim of this systematic review of randomized controlled trials (RCTs) was to summarize the evidence on the effects of antiresorptive drugs on CTIBL in patients with early breast cancer. METHODS: PubMed, Scopus, and Web of Science databases were systematically searched up to April 30, 2021 to identify RCTs satisfying the following PICO model: P) Participants: postmenopausal women with early breast cancer receiving adjuvant aromatase inhibitors (AI), age >18 years; I) Intervention: antiresorptive drugs (i.e. bisphosphonates and/or denosumab); C) Comparator: any comparator; O) Outcome: bone mineral density (BMD) modifications. Moreover, a quality assessment was performed according to the Jadad scale. RESULTS: Out of the initial 2415 records, 21 papers (15 studies) were included in the data synthesis. According to the Jadad scale, 6 studies obtained a score of 5, 1 study obtained a score of 4, 13 studies obtained a score of 3, and 1 study with score 1. Although both bisphosphonates and denosumab showed to increase BMD, only denosumab showed significant advantages on fractures. CONCLUSIONS: Bone health management in patients with early breast cancer receiving adjuvant AIs remains challenging, and the optimal therapeutic approach is not standardized. Further studies are needed to investigate CTIBL, focusing on both the need for antiresorptive drugs and their duration based on individual patients’ characteristics. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero, identifier CRD42021267107.
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spelling pubmed-88144532022-02-05 Efficacy of Antiresorptive Drugs on Bone Mineral Density in Post-Menopausal Women With Early Breast Cancer Receiving Adjuvant Aromatase Inhibitors: A Systematic Review of Randomized Controlled Trials de Sire, Alessandro Lippi, Lorenzo Venetis, Konstantinos Morganti, Stefania Sajjadi, Elham Curci, Claudio Ammendolia, Antonio Criscitiello, Carmen Fusco, Nicola Invernizzi, Marco Front Oncol Oncology BACKGROUND: Cancer treatment-induced bone loss (CTIBL) is a frequent complication of breast cancer therapies affecting both disability and health-related quality of life (HRQoL). To date, there is still a lack of consensus about the most effective approach that would improve bone health and HRQoL. Therefore, the aim of this systematic review of randomized controlled trials (RCTs) was to summarize the evidence on the effects of antiresorptive drugs on CTIBL in patients with early breast cancer. METHODS: PubMed, Scopus, and Web of Science databases were systematically searched up to April 30, 2021 to identify RCTs satisfying the following PICO model: P) Participants: postmenopausal women with early breast cancer receiving adjuvant aromatase inhibitors (AI), age >18 years; I) Intervention: antiresorptive drugs (i.e. bisphosphonates and/or denosumab); C) Comparator: any comparator; O) Outcome: bone mineral density (BMD) modifications. Moreover, a quality assessment was performed according to the Jadad scale. RESULTS: Out of the initial 2415 records, 21 papers (15 studies) were included in the data synthesis. According to the Jadad scale, 6 studies obtained a score of 5, 1 study obtained a score of 4, 13 studies obtained a score of 3, and 1 study with score 1. Although both bisphosphonates and denosumab showed to increase BMD, only denosumab showed significant advantages on fractures. CONCLUSIONS: Bone health management in patients with early breast cancer receiving adjuvant AIs remains challenging, and the optimal therapeutic approach is not standardized. Further studies are needed to investigate CTIBL, focusing on both the need for antiresorptive drugs and their duration based on individual patients’ characteristics. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero, identifier CRD42021267107. Frontiers Media S.A. 2022-01-21 /pmc/articles/PMC8814453/ /pubmed/35127539 http://dx.doi.org/10.3389/fonc.2021.829875 Text en Copyright © 2022 de Sire, Lippi, Venetis, Morganti, Sajjadi, Curci, Ammendolia, Criscitiello, Fusco and Invernizzi https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
de Sire, Alessandro
Lippi, Lorenzo
Venetis, Konstantinos
Morganti, Stefania
Sajjadi, Elham
Curci, Claudio
Ammendolia, Antonio
Criscitiello, Carmen
Fusco, Nicola
Invernizzi, Marco
Efficacy of Antiresorptive Drugs on Bone Mineral Density in Post-Menopausal Women With Early Breast Cancer Receiving Adjuvant Aromatase Inhibitors: A Systematic Review of Randomized Controlled Trials
title Efficacy of Antiresorptive Drugs on Bone Mineral Density in Post-Menopausal Women With Early Breast Cancer Receiving Adjuvant Aromatase Inhibitors: A Systematic Review of Randomized Controlled Trials
title_full Efficacy of Antiresorptive Drugs on Bone Mineral Density in Post-Menopausal Women With Early Breast Cancer Receiving Adjuvant Aromatase Inhibitors: A Systematic Review of Randomized Controlled Trials
title_fullStr Efficacy of Antiresorptive Drugs on Bone Mineral Density in Post-Menopausal Women With Early Breast Cancer Receiving Adjuvant Aromatase Inhibitors: A Systematic Review of Randomized Controlled Trials
title_full_unstemmed Efficacy of Antiresorptive Drugs on Bone Mineral Density in Post-Menopausal Women With Early Breast Cancer Receiving Adjuvant Aromatase Inhibitors: A Systematic Review of Randomized Controlled Trials
title_short Efficacy of Antiresorptive Drugs on Bone Mineral Density in Post-Menopausal Women With Early Breast Cancer Receiving Adjuvant Aromatase Inhibitors: A Systematic Review of Randomized Controlled Trials
title_sort efficacy of antiresorptive drugs on bone mineral density in post-menopausal women with early breast cancer receiving adjuvant aromatase inhibitors: a systematic review of randomized controlled trials
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8814453/
https://www.ncbi.nlm.nih.gov/pubmed/35127539
http://dx.doi.org/10.3389/fonc.2021.829875
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