Bisphosphonates, Annual BMD Screen Up Fracture Prevention

Cost-effective for preventing fractures in postmenopausal women with HR+ breast cancer

WEDNESDAY, Feb. 29 (HealthDay News) -- In a hypothetical model of postmenopausal women receiving adjuvant aromatase inhibitors (AIs) for hormone receptor (HR)-positive early breast cancer (EBC), baseline and annual bone mineral density (BMD) screening followed by selective treatment with oral bisphosphonates for those diagnosed with osteoporosis is a cost-effective strategy, according to a study published online Feb. 27 in the Journal of Clinical Oncology.

Kouta Ito, M.D., of Brigham and Women's Hospital in Boston, and colleagues developed a Markov state transition model to simulate clinical practice and outcomes in a hypothetical cohort of women aged 60 years with HR-positive EBC starting a five-year course of AI therapy following primary surgery for breast cancer. The following strategies were compared: no intervention; one-time BMD screening and selective bisphosphonate therapy in women with osteoporosis or osteopenia; annual BMD screening and selective bisphosphonate therapy in women with osteoporosis or osteopenia; and universal bisphosphonate therapy.

The researchers found that the incremental cost-effectiveness ratio for annual BMD screening followed by oral bisphosphonates for those with osteoporosis was $87,300 per quality-adjusted life-year (QALY) gained; annual BMD screening followed by oral bisphosphonates for those with osteopenia was $129,300 per QALY gained; and universal treatment with oral bisphosphonates was $283,600 per QALY gained. One-time BMD screening followed by oral bisphosphonate therapy for those with osteoporosis or osteopenia was dominated. The results were sensitive to age at the initiation of AI therapy, type of bisphosphonates, post-treatment residual effect of bisphosphonates, and a potential adjuvant benefit of intravenous bisphosphonates.

"In postmenopausal women receiving adjuvant AIs for HR-positive EBC, a policy of baseline and annual BMD screening followed by selective treatment with oral bisphosphonates for those diagnosed with osteoporosis is a cost-effective use of societal resources," the authors write.

Abstract
Full Text (subscription or payment may be required)
Editorial

Copyright © 2012 HealthDay. All rights reserved.

Powered by

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles Recommended Nursing Articles

What internal motivators drive RNs to pursue a BSN?
Nursing2014 , October 2014
Free access will expire on November 24, 2014.


Breast Cancer Risk Assessment in Primary Care
MCN, The American Journal of Maternal/Child Nursing, September/October 2014
Free access will expire on November 10, 2014.


Nurses spurring innovation
Nursing Management, October 2014
Free access will expire on November 10, 2014.


More Recommended Articles

Subscribe to Recommended Articles

Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events