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There is an urgent need to
revise the guidelines associated with the use of AIs as antiresorptive treatment initiated in 15-54% of women was found to be unnecessary.
Aromatase inhibitors (AI) are often
used as hormone therapy drugs to slow down or stop the enlargement of hormone
receptor-positive tumours among postmenopausal women. These inhibitors block
aromatase enzyme, thus reducing body estrogen levels and inhibiting the cancer
growth. The most common side effects associated with their use are bone loss,
increased risk of fractures and osteoporosis.
Tremblay et al. conducted a
retrospective review on postmenopausal women diagnosed and treated for breast
cancer from the period 2010 to 2015. A total of 319 women were included in the
study and assessed further. The median age of patients was 65 years, and the
span of AI therapy defined was 28 months. The DEXA (Dual-energy X-ray
Absorptiometry) scan was performed at the median frequency of 24 months to
analyse the bone loss. The median number of DEXA scan was 1 for every woman.
According to multiple guideline
recommendations, initial antiresorptive treatment among 15–54% of women was
irrelevant. A total of 52 women obtained antiresorptive therapies with
Denosumab, Bisphosphonates or both drugs. The recommendations for Vitamin D and
Calcium were also evaluated, which was 59% and 66 %, respectively.
As per the single healthcare system,
the study determined that about 15–52% antiresorptive treatments were
irrelevant. A specific range of diversity was noticed in guideline
recommendations, which has various implications for cost-effectiveness,
value-of-care analyses and quality of care for preventing
fractures.
Supportive Care in Cancer
Management of bone health in postmenopausal women on aromatase inhibitors (AIs): a single health care system experience.
Douglas Tremblay et al.
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