Effects of zoledronic acid versus placebo on bone mineral density and bone texture analysis assessed by the trabecular bone score in premenopausal women with breast cancer treatment-induced bone loss: results of the ProBONE II substudy

Osteoporos Int. 2015 Jan;26(1):353-60. doi: 10.1007/s00198-014-2955-3. Epub 2014 Nov 8.

Abstract

Changes in bone mineral density (BMD) and trabecular bone score (TBS) were assessed in 70 patients who received either zoledronate (ZOL) (n = 34) or placebo (n = 36) for 2 years. In premenopausal women with breast cancer treatment-induced bone loss, 24 months of intravenous ZOL treatment significantly increased the lumbar spine BMD and the TBS.

Introduction: The aim of this study was to compare the effects of 4 mg intravenous zoledronate (ZOL) versus placebo (PLB), every 3 months, on the lumbar spine (LS) bone mineral density (BMD) and the trabecular bone score (TBS) in premenopausal women with breast cancer (BC) treatment-induced bone loss. The TBS is a gray-level texture measurement which is related to the bone microarchitecture and considered to be independent of the BMD.

Methods: Changes in BMD and TBS were assessed in 70 patients who were recruited in the double-blind, placebo-controlled ProBONE-II trial and randomized to receive either ZOL (n = 34) or PLB (n = 36) for 2 years. The changes were assessed at baseline and at 12 and 24 months after treatment initiation.

Results: Patients receiving ZOL showed a mean increase in LS BMD from the baseline to 12 (2.17%) and 24 months (3.14%) of treatment and a mean increase in the TBS of 2.41 and 0.75%, respectively. Conversely, patients receiving PLB showed a mean decrease in the LS BMD from the baseline to 12 (-5.02%) and 24 (-6.43%) months and a mean decrease of -0.52 and -2.16% in the TBS, respectively. Changes in the BMD and the TBS from the baseline to 12 and 24 months were all significantly different for ZOL compared to PLB (p < 0.005). Furthermore, BMD and TBS showed a moderate correlation ranging from 0.28 (p = 0.087) to 0.47 (p = 0.003).

Conclusions: In premenopausal women with BC, 24 months of intravenous ZOL treatment significantly increased the LS BMD as well as the TBS.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Absorptiometry, Photon / methods
  • Adult
  • Antineoplastic Agents / adverse effects
  • Bone Density / drug effects*
  • Bone Density Conservation Agents / administration & dosage
  • Bone Density Conservation Agents / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / physiopathology
  • Diphosphonates / administration & dosage
  • Diphosphonates / therapeutic use*
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Imidazoles / administration & dosage
  • Imidazoles / therapeutic use*
  • Injections, Intravenous
  • Lumbar Vertebrae / physiopathology
  • Middle Aged
  • Osteoporosis / chemically induced
  • Osteoporosis / drug therapy*
  • Osteoporosis / physiopathology
  • Premenopause / physiology
  • Zoledronic Acid

Substances

  • Antineoplastic Agents
  • Bone Density Conservation Agents
  • Diphosphonates
  • Imidazoles
  • Zoledronic Acid