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Less bone loss in breast cancer with Vitamin D.


CHICAGO -- The bone loss associated with aromatase inhibitors was significantly slowed with increasing supplements of vitamin D in a prospective cohort study of 156 postmenopausal women.

"The bone loss was less, the higher your vitamin D level was maintained," said session chair Dr. Thomas J. Smith of Massey Cancer Center of Virginia Commonwealth University. "This is one of the first intervention studies," he said. 'And the results are pretty striking."


Dr. Sonia Servitja, who is with Hospital del Mar in Barcelona, and colleagues, assessed the association between 25-hydroxy-vitamin D [25(OH)D] concentrations and bone loss at baseline, after 3 months of supplementation, and after 1 year, in patients receiving aromatase inhibitor therapy for early-stage breast cancer.

The 156 women in the prospective cohort had hormone-positive breast cancer and had initiated aromatase inhibitors from January 2006 to June 2009.

All patients received daily oral calcium (1 g) and vitamin [D.sub.3] (800 IU). Patients with a baseline level of 25(OH)D less than 30 ng/mL received additional oral vitamin [D.sub.3]. The women were a mean age of 62 years with a mean age of menopause onset of 50 years.

The magnitude of the bone-loss prevention correlated with incremental increases in 25(OH)D concentrations.

Each 10-ng/mL increase in 25(OH)D concentration at 3 months appeared to be associated with a 0.55% decrease in bone loss, which was almost a third of the average bone loss experienced by these patients, according to the Dr. Sonia Servitja and her associates, who presented the study findings as a poster at the meeting.

The findings suggest that vitamin D supplementation at doses higher than the standard of 400 to 800 IU/day might be useful to minimize bone loss in women starting out on aromatase inhibitors and who are not eligible for bisphosphonate therapy according to current guidelines.

Patients who achieved 25(OH)D concentrations greater than or equal to 40 ng/mL at 3 months experienced significantly reduced bone loss. In addition, 25(OH)D increases at 3 months were protective for relative bone loss (adjusted beta for each quintile 1.01%, P value less than .001).

Among the subset of patients who had baseline deficiency of 25(OH)D, that deficiency appeared directly related to loss of bone mineral density, although this was of borderline significance (P = .07), Dr. Servitja and her associates noted.


Major Finding: 25(0H)D concentration increments due to supplementation prevent aromatase inhibitor-associated bone loss, independently of baseline 25(0H)D concentrations. Increasing levels of 25(0H)D concentrations at 3 months were inversely correlated to absolute bone loss (-0.004 g/[cm.sup.2], [-0.007 to -0.004], (P = .003), at 1 year.

Data Source: Prospective cohort study of 156 postmenopausal nonosteoporotic women using adjuvant aromatase inhibitors in early breast cancer.

Disclosures: Dr. Sonia Servitja disclosed no relevant relationships. Chair and invited discussant Dr. Thomas J. Smith disclosed research funding from the American Cancer Society and the National Cancer Institute

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Title Annotation:WOMEN'S HEALTH
Author:Hyer, Richard
Publication:Family Practice News
Article Type:Report
Geographic Code:1USA
Date:Aug 1, 2011
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