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Use of Bisphosphonates and Other Bone Supportive Agents in the Management of Prostate Cancer - A UK Perspective.

Int J Clin Pract. 2020 Jul 12;:e13611 Authors: Payne H, Bahl A, O'Sullivan JM 

AIM: To explore the practice and views of uro-oncologists in the UK regarding their use of bone supportive agents in patients with prostate cancer. METHODS: An expert-devised online questionnaire was completed by members of the British Uro-oncology Group (BUG). RESULTS: Of 160 uro-oncologists invited, 81 completed the questionnaire. Approximately 70% of respondents never use a bone supportive agent in patients with metastatic hormone-naïve prostate cancer on androgen deprivation therapy (ADT). However, use was more frequent in men with metastatic castration-resistant prostate cancer, from first-line treatment onwards. The majority of uro-oncologists do not use a bone supportive agent to prevent SREs in men with non-metastatic disease, unless the individual patient is at an increased risk of osteoporosis. In men with more advanced disease, respondents would use an oral or intravenous (IV) bisphosphonate in 41% and 61% of patients, respectively. Zoledronic acid is the first-choice bone supportive treatment in 77% of cases, with the lack of clinical data cited as a barrier to use for other IV bisphosphonates. Local guidelines also have a significant influence on the use of bone supportive agents, especially with respect to denosumab. Bone mineral density measurement is conducted in approximately 40% of men with ADT exposure of 2 years or longer, or those with metastatic prostate cancer. CONCLUSION: Uro-oncologists in the UK generally do not use bone supportive agents for men with metastatic hormone-naïve prostate cancer or those with non-metastatic disease. However, increasing duration of ADT and the presence of castration-resistant metastatic prostate cancer increases use. PMID: 32654366 [PubMed - as supplied by publisher]

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