Real-world use of bone modifying agents in metastatic, castration-resistant prostate cancer Journal Article
| Authors: | Mitchell, A. P.; Mishra Meza, A.; Panageas, K. S.; Lipitz-Snyderman, A.; Farooki, A.; Morris, M. J. |
| Article Title: | Real-world use of bone modifying agents in metastatic, castration-resistant prostate cancer |
| Abstract: | Background: Bone modifying agents (BMAs) prevent skeletal related events among patients with metastatic, castration-resistant prostate cancer (mCRPC) involving bone and prevent osteoporotic fractures among patients at high risk. BMA utilization for patients with mCRPC has not been well quantified. Methods: We used linked SEER registry and Medicare claims data. We included men diagnosed with stage IV prostate adenocarcinoma during 2007–2015, aged > = 66 at diagnosis, with sufficient continuous enrollment in Medicare Parts A, B, and D, who received androgen deprivation therapy. We limited to those who subsequently received a CRPC-defining treatment (CDT). We identified patients with evidence of bone metastasis using claims. Our primary outcome was receipt of a BMA (zoledronic acid or denosumab) within 180 days of initiating CDT. Results: Among 1292 included patients, 1034 (80%) had bone metastasis. BMA use within 180 days of initiating CDT was higher among patients with bone metastases than those without (705/1034 [68%] vs 56/258 [22%]). Among patients without bone metastasis, those with high osteoporotic fracture risk were more likely than those without to receive a BMA (OR = 2.48, 95% CI: 1.17, 5.29); however, only 26% of patients with high fracture risk received a BMA. Among patients who received BMAs, most (62%) first initiated them >90 days before initiating CDT. Conclusions: Two-thirds of patients with mCRPC and bone metastases received BMAs within 180 days after initiating CDT. A greater proportion of patients without bone metastasis may warrant BMA therapy for osteoporotic fracture prevention. Some patients with bone metastasis may be able to delay BMA initiation until CRPC. © 2022, The Author(s), under exclusive licence to Springer Nature Limited. |
| Keywords: | aged; bone neoplasms; bone tumor; united states; pathology; medicare; androgen antagonists; antiandrogen; epidemiology; fragility fracture; bone density conservation agent; bone density conservation agents; zoledronic acid; castration resistant prostate cancer; osteoporotic fractures; humans; human; male; prostatic neoplasms, castration-resistant |
| Journal Title: | Prostate Cancer and Prostatic Diseases |
| Volume: | 26 |
| Issue: | 1 |
| ISSN: | 1365-7852 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2023-03-01 |
| Start Page: | 126 |
| End Page: | 132 |
| Language: | English |
| DOI: | 10.1038/s41391-022-00573-y |
| PUBMED: | 35798857 |
| PROVIDER: | scopus |
| PMCID: | PMC10251421 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding author is MSK author Aaron P. Mitchell -- Source: Scopus |
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