Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar 19;15(6):1847.
doi: 10.3390/cancers15061847.

Initiation of Antiresorptive Drug Treatment during Endocrine Therapy for Breast Cancer-A Retrospective Cohort Study of 161,492 Patients in Germany

Niklas Gremke  1 , Sebastian Griewing  1 , Arturas Kadys  1 , Karel Kostev  2 , Uwe Wagner  1 , Matthias Kalder  1
Affiliations

Initiation of Antiresorptive Drug Treatment during Endocrine Therapy for Breast Cancer-A Retrospective Cohort Study of 161,492 Patients in Germany

Niklas Gremke et al. Cancers (Basel). .

Abstract

Background: The aim of this retrospective cohort study was to measure the proportion of women with an initial prescription of an antiresorptive drug (bisphosphonates or denosumab) during five years of endocrine breast cancer therapy.

Methods: The study included women with an initial prescription of tamoxifen (TAM) or aromatase inhibitors (AIs) between January 2016 and December 2020. Kaplan-Meier analyses were performed to show the cumulative incidence of antiresorptive drug prescription for TAM and AIs separately for four age groups. A univariable Cox proportional hazards regression model was also used to estimate the relationship between initial endocrine drug (AIs vs. TAM) and antiresorptive drug prescription.

Results: Within 5 years, 14.1% of patients on AI and 6.1% on TAM received their first prescription for an antiresorptive drug (p < 0.001). The difference between AI and TAM was greatest in women ≤50 years (12.9% of AI and 2.8% of patients on TAM), and smallest in women >80 years (14.5% of AI and 10.3% of patients on TAM). The proportion of denosumab was 46.2% among AI patients vs. 29.1% among patients on TAM (p < 0.001) as alendronate was prescribed to 36.9% of AI vs. 50.0% of patients on TAM.

Conclusions: Across all age groups, the cumulative incidence of antiresorptive drug prescriptions was higher in patients with BC treated with AI than those receiving TAM. Denosumab was most frequently used as an antiresorptive drug in patients treated with AI, while alendronate was administered more often in patients treated with TAM.

Keywords: Germany; antiresorptive therapy; aromatase inhibitors; bisphosphonates; breast cancer; denosumab; endocrine therapy; tamoxifen.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Cumulative incidence of antiresorptive drug prescription among women treated with TAM and AIs.
Figure 2
Figure 2
Antiresorptive drugs prescribed in women treated with TAM and AIs (100% = patients with at least one antiresorptive drug prescription).
See this image and copyright information in PMC

References

    1. Smolarz B., Nowak A.Z., Romanowicz H. Breast Cancer-Epidemiology, Classification, Pathogenesis and Treatment (Review of Literature) Cancers. 2022;14:2569. doi: 10.3390/cancers14102569. - DOI - PMC - PubMed
    1. Harbeck N., Penault-Llorca F., Cortes J., Gnant M., Houssami N., Poortmans P., Ruddy K., Tsang J., Cardoso F. Breast cancer. Nat. Rev. Dis. Primers. 2019;5:66. doi: 10.1038/s41572-019-0111-2. - DOI - PubMed
    1. Early Breast Cancer Trialists’ Collaborative G., Davies C., Godwin J., Gray R., Clarke M., Cutter D., Darby S., McGale P., Pan H.C., Taylor C., et al. Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: Patient-level meta-analysis of randomised trials. Lancet. 2011;378:771–784. doi: 10.1016/S0140-6736(11)60993-8. - DOI - PMC - PubMed
    1. Waks A.G., Winer E.P. Breast Cancer Treatment: A Review. JAMA. 2019;321:288–300. doi: 10.1001/jama.2018.19323. - DOI - PubMed
    1. Tong C.W.S., Wu M., Cho W.C.S., To K.K.W. Recent Advances in the Treatment of Breast Cancer. Front. Oncol. 2018;8:227. doi: 10.3389/fonc.2018.00227. - DOI - PMC - PubMed

LinkOut - more resources