Incidence of bone fracture in patients receiving luteinizing hormone-releasing hormone agonists for prostate cancer

BJU Int. 2000 Sep;86(4):449-52. doi: 10.1046/j.1464-410x.2000.00774.x.


Objective: To investigate the incidence of bone fractures in patients receiving luteinizing hormone-releasing hormone agonists (LHRH-a) for prostate cancer (in whom a continued low testosterone level after the long-term administration of these drugs reduces bone mineral density), and thus determine the risk of secondary osteoporosis.

Patients and methods: Between 1994 and 1999, 218 patients (mean age 77.3 years) were treated for >/= 6 months with LHRH-a for prostate cancer; of these, 14 (6%) had a bone fracture during their treatment. Patients with fracture associated with motor vehicle accidents were excluded. The bone density in the third lumbar vertebra was meas-ured using quantitative computed tomography. Osteocalcin, 1,25-(OH)2 vitamin D, urinary type 1 collagen cross-linked N-telopeptides (NTx), parathyroid hormone and calcitonin were measured as metabolic markers.

Results: The mean age of the patients with fracture was 78 years; the mean (range) interval from the start of treatment to fracture was 28 (11-46) months. There was no case of a bone fracture at the site of a metastasis from prostate cancer. The bone density was significantly lower in the patients with a fracture than in those without. Of the bone metabolic markers, NTx was higher in those with a fracture.

Conclusion: There is a need to measure bone mineral density and bone metabolic markers periodically, and to evaluate secondary osteoporosis in patients receiving long-term LHRH-a for prostate cancer.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Antineoplastic Agents, Hormonal / adverse effects
  • Bone Density
  • Fractures, Spontaneous / chemically induced*
  • Gonadotropin-Releasing Hormone / agonists*
  • Goserelin / adverse effects
  • Humans
  • Leuprolide / adverse effects
  • Lumbar Vertebrae
  • Male
  • Middle Aged
  • Prostatic Neoplasms / drug therapy*
  • Risk Factors


  • Antineoplastic Agents, Hormonal
  • Goserelin
  • Gonadotropin-Releasing Hormone
  • Leuprolide