Benefits and harms of antiresorptive therapy in men with non-metastatic prostate cancer on androgen deprivation therapy: A systematic review and meta-analysis of randomized controlled trials.
MetabolismJun 9, 2026 (epub)
Aya Bassatne, Nour El Meski, Renee Horanieh et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the effects of antiresorptive therapy on bone health in men with non-metastatic prostate cancer undergoing androgen deprivation therapy (ADT). The analysis included 26 randomized controlled trials. Denosumab was associated with a significant reduction in new morphometric vertebral fracture risk at 12, 24, and 36 months (RR = 0.15, 0.31, and 0.38, respectively).
Key findings
- Denosumab likely reduces new morphometric vertebral fracture risk at 12 months (RR = 0.15).
- Intravenous bisphosphonates showed no effect on morphometric vertebral fractures at 36 months (RR = 1.06).
- Treatment increased bone mineral density at the hip (+1.5 to +3.9%) and lumbar spine (+4.0 to +6.8%).
- Gastrointestinal issues were the most common adverse events across all antiresorptives.
Why it matters
The findings highlight the potential of denosumab in reducing fracture risk and improving bone mineral density in men with prostate cancer on ADT, addressing a significant concern of bone health in this population.