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Joint Position Statement on Bone Loss Associated With Aromatase Inhibitors

Posted: Thursday, June 15, 2017

Seven international and European organizations have issued a joint position statement identifying fracture-related risk factors in patients treated with aromatase inhibitors and outlining management strategies to help prevent bone loss and related fractures. This new position statement was published by Hadji et al in the Journal of Bone Oncology.

The statement is authored by experts from the International Osteoporosis Foundation; the Cancer and Bone Society; the International Expert Group for Aromatase Inhibitor–Associated Bone Loss; the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis, and Musculoskeletal Diseases; the European Calcified Tissue Society; the International Menopause Society; and the International Society for Geriatric Oncology.

Here are a few key highlights from the position statement:

  • In all patients initiating aromatase inhibitor treatment, fracture risk should be assessed and recommendations given in regard to exercise and calcium/vitamin D supplementation.
  • Based on current evidence, 6-monthly denosumab or yearly zoledronic acid for the duration of aromatase inhibitor therapy is recommend for the prevention of aromatase inhibitor–associated bone loss in postmenopausal women receiving adjuvant aromatase inhibitor therapy, with zoledronic acid recommended when effects on disease recurrence are the priority and denosumab recommended when fracture risk is the dominant concern.
  • Because of the decreased incidence of bone recurrence and breast cancer–specific mortality associated with bisphosphonate use, adjuvant bisphosphonates are recommended for all postmenopausal women at significant risk of disease recurrence.