Academic Unit of Bone Metabolism, University of Sheffield, Sheffield.
Diagnostic Radiology, Imaging Science and Biomedical Engineering, University of Manchester, Manchester.
Ann Oncol. 2011 Apr;22(4):857-862. doi: 10.1093/annonc/mdq541. Epub 2010 Oct 7.
This 'Arimidex', Tamoxifen, Alone or in Combination (ATAC) trial sub-study examined the effects of anastrozole and tamoxifen on bone mineral density (BMD) following 5 years of treatment.
Lumbar spine and total hip BMD were assessed at years 6 and 7 in a total of 71 eligible patients. In total, 50 patients had evaluable data.
Following anastrozole treatment, the lumbar spine median BMD increased by 2.35% (P=0.04) and 4.02% (P=0.0004) at years 6 and 7, while total hip median BMD increased by 0.71% (P=0.3) and 0.5% (P=0.8). After tamoxifen treatment, lumbar spine median BMD decreased by 0.79% (P=0.2) and 0.30% (P=0.9) at years 6 and 7, while total hip median BMD decreased by 2.09% (P=0.0003) and 2.52% (P=0.0002). Patients with a normal BMD or who were osteopenic at 5 years did not become osteoporotic.
Anastrozole treatment-related bone loss did not continue into the off-treatment follow-up period. The recovery in lumbar spine BMD and absence of further loss at the hip is consistent with the reduction in the annual rate of fracture observed after treatment cessation in the main ATAC trial.
这项阿那曲唑、他莫昔芬、单用或联合（ATAC）试验子研究检查了阿那曲唑和他莫昔芬对治疗 5 年后骨密度（BMD）的影响。
共有 71 名符合条件的患者在第 6 年和第 7 年评估了腰椎和全髋关节 BMD。共有 50 名患者有可评估的数据。
阿那曲唑治疗后，腰椎 BMD 中位数在第 6 年和第 7 年分别增加了 2.35%（P=0.04）和 4.02%（P=0.0004），全髋关节 BMD 中位数分别增加了 0.71%（P=0.3）和 0.5%（P=0.8）。他莫昔芬治疗后，腰椎 BMD 中位数在第 6 年和第 7 年分别下降了 0.79%（P=0.2）和 0.30%（P=0.9），全髋关节 BMD 中位数分别下降了 2.09%（P=0.0003）和 2.52%（P=0.0002）。在 5 年内 BMD 正常或骨质疏松的患者并未进展为骨质疏松症。
阿那曲唑治疗相关的骨质流失并未持续到停药随访期。腰椎 BMD 的恢复和髋关节无进一步的骨质流失与治疗停止后主要 ATAC 试验中观察到的骨折年发生率降低一致。
