EYES2024 ESE Young Endocrinologists and Scientists (EYES) 2024 Calcium and Bone (9 abstracts)
Bone-active drugs in pre-menopausal women with breast cancer undergoing hormone deprivation therapies
Maria Francesca Birtolo 1,2 , Rebecca Pedersini 3 , Andrea Palermo 4,5 , Walter Vena 1,6 , Emanuela Morenghi 1,7 , Giacomo Cristofolini 1,2 , Barbara Presciuttini 8 , Gaia Tabacco 4 , Anda Mihaela Naciu 4 , Stella Pigni 1,2 , Marta Laganà 3 , Federica Mazzoleni 5 , Deborah Cosentini 3 , Antea Ciafardini 1,2 , Mauro Pagani 8 , Davide Farina 9 , Luca Balzarini 10 , Alberto Zambelli 1,11 , Rosalba Torrisi 11 , Luisella Cianferotti 12 , Nicola Napoli 4,5,13 , Antonio Carlo Bossi 5 , Andrea Gerardo Lania 1,2 , Alfredo Berruti 3 & Gherardo Mazziotti 1,2
1Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele-Milan, Italy; 2Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano-Milan, Italy; 3Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Medical Oncology, University of Brescia, ASST Spedali Civili, 25123 Brescia, Italy; 4Unit of Metabolic Bone and Thyroid Diseases, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; 5Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, 00128 Rome, Italy; 6Diabetology and Endocrinology, Humanitas Gavazzeni, 24125 Bergamo, Italy; 7Biostatistics Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano-Milan, Italy; 8Endocrinology Unit, Department of Medicine, ASST Carlo Poma, 46100 Mantua, Italy; 9Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Radiology, University of Brescia, ASST Spedali Civili, 25123 Brescia, Italy; 10Department of Radiology, IRCCS Humanitas Research Hospital, 20089 Rozzano-Milan, Italy; 11Cancer Center, IRCCS Humanitas Research Hospital, 20089 Rozzano-Milan, Italy; 12Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy; 13Division of Bone and Mineral Diseases, Washington University in St Louis, St Louis, MO 63130, United States
Background: Bone health management in pre-menopausal women with breast cancer (BC) under hormone-deprivation therapies (HDTs) is often challenging, and the effectiveness of bone-active drugs is still unknown.
Methods: This retrospective multicenter study included 306 premenopausal women with early BC undergoing HDTs. Bone mineral density (BMD) and morphometric vertebral fractures (VFs) were assessed 12 months after HDTs initiation and then after at least 24 months.
Results: After initial assessment, bone-active drugs were prescribed in 77.5% of women (151 denosumab 60 mg/6 months, 86 bisphosphonates). After 47.0±20.1 months, new VFs were found in 16 women (5.2%). VFs risk was significantly associated with obesity [OR 3.87, P = 0.028], family history of hip fractures or VFs (OR 3.21, P = 0.040], chemotherapy-induced menopause (OR 6.48, P < 0.001), pre-existing VFs (OR 25.36, P < 0.001), baseline T-score ≤-2.5 SD at any skeletal site (OR 4.14, P = 0.036) and changes at lumbar and total hip BMD (OR 0.94, P = 0.038 and OR 0.88, P < 0.001, respectively). New VFs occurred more frequently in women untreated compared to those treated with bone-active drugs (14/69, 20.8% vs. 2/237, 0.8%; P < 0.001) and the anti-fracture effectiveness remained significant after correction for BMI (OR 0.033; P < 0.001), family history of fractures (OR 0.030; P < 0.001), chemotherapy-induced menopause (OR 0.04; P < 0.001) and pre-existing VFs (OR 0.014; P < 0.001).
Conclusions: Pre-menopausal women under HDTs are at high risk of VFs in relationship with high BMI, densitometric diagnosis of osteoporosis, pre-existing VFs and family history of osteoporotic fractures. VFs in this setting might be effectively prevented by bisphosphonates or denosumab.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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