Safety and efficacy of Zoledronic acid on bone minerals density in prostate cancer patients undergoing Androgen deprivation therapy Hagar Bessar 1* , Ahmed Negida 1 , Yasmin Hani 1 , Ahmed Menshawy 2 , Esraa Ghanem 2 , Ahmed Adel 3 , Noura Attallah 3 , Hagar Ahmed 3 This study aims at synthesizing evidence from published RCTs about safety and efficacy of Zoledronic acid (ZA) on bone mineral density (BMD) for prostate cancer (PCa) patients undergoing androgen deprivation therapy (ADT). We searched PubMed through September 2014 using relevant key words “zoledronic acid”, “prostate cancer”, and “bone”. Data were extracted from eligible studies, quality was assessed in strict accordance to Cochrane handbook and data were analyzed using RevMan 5.3 for windows. INTRODUCTION METHODS RESULTS Abstract Reference No.0897 3- Faculty of medicine, Menoufia University, Egypt 4- Faculty of medicine, Cairo University, Egypt 1- Faculty of medicine, Zagazig University, Egypt 2- Faculty of medicine, Al-Azhar University, Egypt Eight RCTs with a total of 713 patients were eligible for this study. Of the six adverse events we analyzed (arthralgia, constipation, fatigue, fever, respiratory infection and hot flashes), fever and fatigue were more common in Zoledronic acid group than control group (RR=1.49, 95% CI=[1.04, 2.12] and RR=4.27, 95% CI=[1.59,11.44]) respectively. The FIGURE shows forest plots of mean difference MD of change in BMD in pelvic bones: (A) Lumbar Spine, (B) Lumbar spine: sensitivity analysis excluding the two unblinded RCTs, (C) Total Hip and (D) Femoral neck. CONCLUSION Intravenous ZA was safe and tolerated in this population. ZA achieved therapeutic success (>3% change in BMD) in patients with PCa undergoing ADT with less adverse events. REFERENCES 1. Smith, M. R. et al. Randomized controlled trial of zoledronic acid to prevent bone loss in men receiving androgen deprivation therapy for nonmetastatic prostate cancer. J. Urol. 169, 2008–12 (2003). 2. Ryan, C. W., Huo, D., Demers, L. M., Beer, T. M. & Lacerna, L. V. Zoledronic acid initiated during the first year of androgen deprivation therapy increases bone mineral density in patients with prostate cancer. J. Urol. 176, 972–8; discussion 978 (2006). 3. Israeli, R. S. et al. The Effect of Zoledronic Acid on Bone Mineral Density in Patients Undergoing Androgen Deprivation Therapy. Clin. Genitourin. Cancer 5, 271–277 (2007). 4. Michaelson, M. D. et al. Randomized controlled trial of annual zoledronic acid to prevent gonadotropin-releasing hormone agonist-induced bone loss in men with prostate cancer. J. Clin. Oncol. 25, 1038–42 (2007). 5. Ryan, C. W. et al. Suppression of bone density loss and bone turnover in patients with hormone-sensitive prostate cancer and receiving zoledronic acid. BJU Int. 100, 70–5 (2007). 6. Bhoopalam, N. et al. Intravenous zoledronic acid to prevent osteoporosis in a veteran population with multiple risk factors for bone loss on androgen deprivation therapy. J. Urol. 182, 2257–64 (2009). 7. Satoh, T. et al. Single infusion of zoledronic acid to prevent androgen deprivation therapy-induced bone loss in men with hormone-naive prostate carcinoma. Cancer 115, 3468–74 (2009). 8. Kachnic, L. A. et al. RTOG 0518: randomized phase III trial to evaluate zoledronic acid for prevention of osteoporosis and associated fractures in prostate cancer patients. Prostate Cancer Prostatic Dis. 16, 382–6 (2013). View publication stats View publication stats