IOF releases position paper on fracture prevention for patients with cancer-associated bone disease

The International Osteoporosis Foundation (IOF) has released a position paper that identifies cancer patients as most at risk for bone disease and fractures and outlines recommendations from different societies on fracture prevention for these patients.

“Physicians must make a concerted effort to prevent bone loss and fractures in their patients. Fragility fractures due to osteoporosis can have serious repercussions, including severe pain, immobility, and accompanying loss of quality of life,” lead author of the paper, René Rizzoli, MD, of the Division of Bone Diseases at University Hospitals and Faculty of Medicine of Geneva, in Switzerland, stated in an International Osteoporosis Foundation (IOF) press release. “Patients with cancer, including those who are in remission, should not have their quality of life further jeopardized by disability resulting from fractures.”

Based on information in the press release, cancer therapy can cause fractures and bone loss, “especially in the case of glucocorticoid or estrogen deprivation therapy, chemotherapy-induced ovarian failure and androgen deprivation therapy.” Rizzoli and colleagues noted in the report that women who receive therapy for breast cancer without bone metastases have a fivefold higher incidence of vertebral fracture compared to women of the same age without cancer, and that decrease in bone mineral density within the first year of therapy ranges from 3% to 5.6%.

The researchers recommended using bisphosphonates, denosumab and other bone-modifying agents to reduce the risk of cancer-related fracture in this patient population.

“Recommendations for assessment and treatment with bone modifying therapies are highly targeted to the type of cancer, and depend on whether or not bone metastasis is involved and whether the bone loss is treatment induced,” Cyrus Cooper, MA, DM, FRCP, FFPH, FMedSci, chair of the IOF Committee of Scientific Advisors, stated in the press release. “This IOF review gives physicians a comprehensive understanding of the key clinical considerations involved and directs attention to the recommendations of the expert societies in the field.”

The IOF Committee of Scientific Advisors has endorsed this position paper.

Reference:

Rizzoli R. Osteoporos Int. 2013;doi:10.1007/s00198-013-2530-3.

Disclosure: The authors report various financial disclosures. Please see the full study for a complete list of disclosures.