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At least 127 records · Page 7Linked to original sources
PubMed2006

Bacterial expression of a Trichosanthes kirilowii defensin (TDEF1) and its antifungal activity on Fusarium oxysporum.

The gene encoding Trichosanthes kirilowii defensin (TDEF1) was cloned by reverse transcriptase-polymerase chain reaction (RT-PCR). The newly discovered TDEF1 cDNA contains 231 bp (Genbank accession number DQ526373) and encodes a 76-amino acid protein, which consists of a 29-amino acid signal peptide and a 47-amino acid mature peptide. The partial cDNA, corresponding to the mature peptide coding region of TDEF1, was inserted into bacterial expression vector pET32a(+). Subsequent expression showed that TDEF1 was produced as a 26-kDa fusion protein in the form of inclusion body in Escherichia coli BL21 (DE3). After protein refolding and purification, the fusion TDEF1 displayed an inhibitive activity against the fungal pathogen, Fusarium oxysporum, with EC(50) of 247 microg/ml by means of fungal growth inhibition method.

Antifungal Agents↗
PubMed2006

Intramedullary cervical tuberculoma.

STUDY DESIGN: Case report. OBJECTIVE: To report a rare lesion of intramedullary cervical tuberculoma. SETTING: Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Chongqing, The People's Republic of China. CASE REPORT: A 15-year-old boy presented with pain in the neck and shoulder. Examination showed mild left hemiplegia and pinprink hyperalgesia on the left side up to C3 level. Chest X-ray and CT scan showed patch and dot lesions indicating old tuberculous lesions and MRI showed a ring-enhancing intramedullary lesion at C3/4 level. Tuberculoma resection and antituberculous therapy was given. There was satisfactory recovery clinically. CONCLUSION: Intramedullary cervical tuberculoma is a rare, coexisting systemic tuberculosis and MRI scan helps in obtaining a correct diagnosis; combining surgery with anti-tuberculosis therapy is the treatment of choice.

Adolescent↗
PubMed2003

Avian influenza attributable to serovar H7N1 in light layers in Italy.

In March 1999 a syndrome characterized by depression, anorexia, fever, and respiratory and enteric signs appeared in many flocks of turkeys and, to a lesser extent, chickens in the densely populated poultry-rearing regions of Northeastern Italy. Initially the disease was characterized by sinusitis, tracheitis, peritonitis, and pancreatitis. The responsible agent was identified as low-pathogenicity (LP) avian influenza (AI) of H7N1 subtype. Concerning the light layers, the mortality was variable, from 1.7% to 9.5%, whereas egg production decreased by 10% to 40%. According to the epidemiologic data, chickens seemed to be less sensitive to the virus than were turkeys. Nine months later, the AI virus changed to a highly pathogenic (HP) AI virus and affected, besides turkeys, a great number of pullet and layer flocks, with high mortality (80%-100%) in a few days. However, the course of disease was more prolonged in pullets. Within 3 1/2 mo, over 100 outbreaks were reported. Following the HPAI outbreaks, in late 2000 and early 2001, LPAI reemerged, but only one flock of layers was affected.

Animals↗
PubMed2007

[Predictive role of diagnostic information in treatment efficacy of rheumatoid arthritis based on neural network model analysis].

OBJECTIVE: To analyze the indications of the therapies for rheumatoid arthritis (RA) with neural network model analysis. METHODS: Three hundred and ninety-seven patients were included in the clinical trial from 9 clinical centers. They were randomly divided into Western medicine (WM) treated group, 194 cases; and traditional Chinese herbal medicine (CM) treated group, 203 cases. A complete physical examination and 18 common clinical manifestations were prepared before the randomization and after the treatment. The WM therapy included voltaren extended action tablet, methotrexate and sulfasalazine. The CM therapy included Glucosidorum Tripterygii Totorum Tablet and syndrome differentiation treatment. The American College of Rheumatology 20 (ACR20) was taken as efficacy evaluation. All data were analyzed on SAS 8.2 statistical package. The relationships between each variable and efficacy were analyzed, and the variables with P<0.2 were included for the data mining analysis with neural network model. All data were classified into training set (75%) and verification set (25%) for further verification on the data-mining model. RESULTS: Eighteen variables in CM and 24 variables in WM were included in the data-mining model. In CM, morning stiffness, swollen joint number, peripheral immunoglobulin M (IgM) level, tenderness joint number, tenderness, rheumatoid factor (RF), C-reactive protein (CRP) and joint pain were positively related to the efficacy, and disease duration and more urination at night negatively related to the efficacy. In WM, erythrocyte sedimentation rate (ESR), weak waist, white fur in tongue, joint pain, joint stiffness and swollen joint were positively related to the efficacy, and yellow fur in tongue, red tongue, white blood negatively related to the efficacy. In the analysis with the neural network model in the patients of verification set, the predictive response rates of 20% patients would be 100% and 90% in the treatment with CM and WM, respectively. CONCLUSION: Neural network model analysis, based on the full clinical trial data with collection of both traditional Chinese medicine and modern medicine diagnostic information, shows a good predictive role for the information in the efficacy in rheumatoid arthritis.

Adult↗
PubMed2007

[Effects of inactivated rabbit serum containing compound realgar and natural indigo tablet on cell line NB4].

OBJECTIVE: To explore the effects of inactivated rabbit serum containing compound realgar and natural indigo tablet (CRNIT) on cell line NB(4). METHODS: The experimental rabbits were taken as the provider of the animal serum, and the serum was inactivated before the experiment. The serum was divided into two groups based on whether the rabbits were given CRNIT. The concentration of arsenic in the rabbit's serum was detected by AFS-230a double path atom fluorescence photometer. The inhibition rates and apoptosis rates were regarded as the observational indexes. RESULTS: The concentration of arsenic in the inactivated rabbit serum containing and not containing the drug were (0.010 0+/-0.001 0) mg/L and (0.110 0+/-0.006 4) mg/L respectively, and the difference had statistical significance (P<0.01). The two groups of serum all had inhibitory effect on the growth of NB(4) cells depending on the drug concentration and effect time. And there were significant differences among the groups. The two groups of serum all induced the apoptosis of NB(4) with positive relations with the concentration and effect time. And there were significant differences among the groups. CONCLUSIONS: The rabbit serum containing CRNIT can obviously restrain the growth of NB(4) cells and the inhibitory effect depends on the concentration and effect time. And the rabbit serum containing CRNIT can also induce the apoptosis of NB(4) cell line and the apoptosis rates depend on the concentration and effect time.

Animals↗
PubMed2005

Effects of interferon-alpha on expression of hepatic stellate cell and transforming growth factor-beta1 and alpha-smooth muscle actin in rats with hepatic fibrosis.

AIM: To investigate the effect of interferon-alpha (IFN-alpha) on preventing or reversing hepatic fibrosis in rat experimental model induced by CCl(4). METHODS: One hundred and ten Sprague-Dawley rats were divided into five groups: group A (normal controls, n=18), group B (fibrotic model controls, n = 22), group C (IFN-alpha prevention, n=22) initially treated with intra-muscular injection of IFN-alpha in saline daily at the doses of 1X105 U for 6 wk, group D (IFN-alpha treatment, n = 24) treated with intra-muscular injection of IFN-alpha in saline daily at the doses of 1X105 U for 6 wk after the first 6 wk, group E (0.9% sodium chloride treatment control, n = 24) treated with intra-muscular injection of 0.01 mL/kg daily for 6 wk after the first 6 wk. At the end of the experiment, all rats of each group were killed. Samples of the liver obtained by biopsy were subjected to histological, immunohistochemical and electron microscopic studies for the expressions of transforming growth factor-beta1 (TGF-beta1) and alpha-smooth muscle actin (alpha-SMA). RESULTS: The expressions of TGF-beta1, the number of activated hepatic stellate cells and alpha-SMA in hepatic tissue of group C were significantly less than those of group B (P<0.01). The degree of fibrosis score in group B was also significantly less than that of group C under light microscope (P<0.01). CONCLUSION: IFN-alpha can inhibit the production of TGF-beta1, decrease HSC activation and stimulate its apoptosis.

Actins↗
PubMed2004

[Studies on anti-inflammatory and immunologic enhancement of kangning granules].

OBJECTIVE: To investigate the effect of Kangning granules on inflammatory and immunology. METHOD: Pedal swelling induced by 1% agar in mice, dermal capillary hyper-permeability induced by histamine in rats were used to evaluate the anti-inflammatory of Kangning granules, and the clearance rate of intravenous charcoal particles was used to study its effect on non-specific immunologic functions. Serum haemolysin level and the number of antibody secretory cells in spleen were determined to assess its effects of specific immunologic functions. MTT colored method was used to determine the effect of Kangning granules on T- or B-Lymphocytes proliferation. RESULT: 5, 10, 20 g x kg(-1) of Kangning Granules significantly inhibited pedal swelling induced by agar in mice (P < 0.05, P < 0.01). 2.4, 4.8, 9.6 g x kg(-1) of Kangning Granules evidently decreased dermal capillary hyper-permeability induced by histamine in rats (P < 0.05, P < 0.01). 10, 20 g x kg(-1) of Kangning Granules enhanced the phagocytic function and phagocytosing velocity in mice (P < 0.05). 5, 10, 20 g x kg(-1) of Kangning Granules obviously increased serum haemolysin level and the number of antibody secretory cells in spleen (P < 0.05, P < 0.01). 20 g x kg(-1) of Kangning Granules promoted B-Lymphocytes proliferation (P < 0.05). CONCLUSION: Kangning granules significantly inhibited inflammatory reaction and increase immune functions in animals.

Animals↗
PubMed2006

[Effects of anti-HER-2 chimeric antibody chA21 on proliferative inhibition of SKOV3 cells and inducing their apoptosis].

AIM: To explore the effects of anti-HER-2 chimeric antibody chA21 on proliferation and apoptosis of ovarian cancer cell lines SKOV3. METHODS: MTT colorometric assay, HE staining, transmission electron microscopy, flow cytometry and TUNEL staining were used to study the proliferative inhibition and apoptotic induction of SKOV3 cells by chA21 in vitro. RESULTS: Proliferative inhibition rate and apoptotic rate of SKOV3 cells were increased with dose and action time by chA21 (0.2 mg/L-5.4 mg/L). CONCLUSION: chA21 can remarkably inhibit proliferation of SKOV3 cells in vitro and induction of apoptosis may be a principal way.

Antibodies↗
PubMed1999

Activation of Rb and decline in androgen receptor protein precede retinoic acid-induced apoptosis in androgen-dependent LNCaP cells and their androgen-independent derivative.

Androgen ablation-induced prostate cancer regression is transient and ends with the regrowth of androgen-independent (AI) tumors. To mimic this evolution in culture, we chronically deprived an androgen-dependent (AD) prostate cancer cell line (LNCaP) of androgen, generating an AI derivative which retained limited hormone proliferative responsiveness and a barely detectable prostate-specific antigen (PSA) mRNA level. While the cytokeratin 8 (CK8) level was low, the androgen receptor (AR) protein in AI cells was on average tenfold greater than in AD cells. When challenged for susceptibility to undergo apoptosis, the AI cells were more resistant than AD cells to all-trans retinoic acid (tRA) and two chemotherapeutic agents, Taxol and Adriamycin, requiring higher doses and longer periods of treatment to achieve similar effects. Compared to AD cells, the partially apoptosis-resistant AI cells expressed four times more Bcl-2 protein and undetectable levels of p21/WAF1. Induction of apoptosis by tRA in both cell types did not affect their expression but was preceded by the activation of Rb and a pronounced reduction of AR protein level. The kinetics of the Rb activation and AR downmodulation in both cell types matched their tRA sensitivity, suggesting that these events may be required for tRA-induced apoptosis. The results show that the apoptotic pathway in AI cells, although more difficult to induce, is not irrevocably lost and that targeted reduction of the AR protein level with retinoids in combination with androgen ablation therapy may prolong remissions in advanced prostate cancer patients.

Antigens, Surface↗
PubMed2005

Oral anti-oestrogens and medical adjuncts for subfertility associated with anovulation.

BACKGROUND: Infertility due to anovulation is a common problem in women. The first line oral treatment is with anti-oestrogens, such as clomiphene citrate. Unfortunately there may be resistance and alternative and adjunctive treatments have been developed. These include tamoxifen, dexamethasone, bromocriptine and aromatase inhibitors (AIs). OBJECTIVES: To determine the relative effectiveness of anti-oestrogen agents, with or without medical adjuncts, in women with WHO group 2 anovulation. SEARCH STRATEGY: We searched the Cochrane Menstrual Disorders and Subfertility Group trial register (searched 5th July 2004), CENTRAL (The Cochrane Library Issue 2 2004), MEDLINE (1966 to June 2004) and EMBASE (1980 to June 2004) for identification of relevant randomised controlled trials (RCTs). Additionally the United Kingdom National Institute for Clinical Excellence (NICE) guidelines and the references of relevant reviews and RCTs were searched. SELECTION CRITERIA: RCTs that compare oral anti-oestrogen agents for ovulation induction (alone or in conjunction with medical adjuncts) in anovulatory subfertility, were considered for inclusion in the review. Metformin and other insulin sensitizing agents were not included. Hyperprolactinaemic infertility was not included. DATA COLLECTION AND ANALYSIS: Data extraction and quality assessment was done independently by two reviewers. The primary outcome was live birth, secondary outcomes were: pregnancy, ovulation, miscarriage, multiple pregnancy, overstimulation, ovarian hyperstimulation syndrome and patient reported adverse effects. MAIN RESULTS: Twelve RCTs were found and included in this review. No trials reported live birth as an outcome. Miscarriage and multiple pregnancy rates were poorly reported. Clomiphene was shown to be effective in increasing pregnancy rate when compared to placebo (fixed OR 5.8, 95% CI 1.6 to 21.5; NNT 5.9, 95% CI 3.6 to 16.7). No evidence of a difference in effect was found between clomiphene and tamoxifen (fixed OR 1.0, 95% CI 0.5 to 2.1). The use of clomiphene in combination with tamoxifen did not find any evidence of effect on pregnancy rate when compared to clomiphene alone (fixed OR 3.3, 95% CI 0.1 to 91.6). The comparison between two AIs (letrozole and anastrozole) did not find any evidence of a difference in effect on pregnancy rate (fixed OR 1.9, 95% CI 0.4 to 8.9). For the intervention of clomiphene plus ketoconazole vs clomiphene no evidence of a difference in effect for pregnancy rate was found (fixed OR 2.4, 95% CI 0.9 to 6.4). For clomiphene plus bromocriptine vs clomiphene no evidence of a difference in effect on pregnancy rate was found (fixed OR 1.0, 95% CI 0.3 to 3.0) rates. However, clomiphene plus dexamethasone treatment resulted in a significant improvement in the pregnancy rate (fixed OR 11.3, 95% CI 5.3 to 24.0; NNT 2.7, 95% CI 2.1 to 3.6) when compared to clomiphene alone as did clomiphene plus pretreatment with combined oral contraceptives (fixed OR 27.2, 95% CI 3.1 to 235.0; NNT 2.0, 95% CI 1.4 to 3.4). AUTHORS' CONCLUSIONS: This review shows evidence supporting the effectiveness of the current first line treatment, clomiphene citrate. No evidence of a difference in effect was found between clomiphene and tamoxifen. The use of dexamethasone as an adjunct to clomiphene therapy appears promising as do combined oral contraceptives. This review has highlighted a gap in the literature on effects of these drugs on outcomes such as miscarriage rate. Evidence in favour of these interventions is flawed. RCTs of adequate power and of high methodological quality are required for the older treatments such as clomiphene, alone and with medical adjuncts, and also for the newer drugs such as the AIs.

Anovulation↗
PubMed2006

Effects of third-generation aromatase inhibitors on bone.

Low oestradiol levels in women are associated with decreased bone mineral density (BMD) and increased fracture risk. The third-generation aromatase inhibitors (AIs; anastrozole, letrozole, and exemestane) are used in the treatment of early and advanced breast cancer and act by substantially reducing oestrogen synthesis in postmenopausal women. However, due to their mechanism of action, there is concern regarding the long-term effects of these agents on bone, particularly when used in the adjuvant setting. In this paper, the currently available data on the effects of the third-generation AIs on markers of bone turnover, BMD, and fracture risk are reviewed, with the emphasis on results in the adjuvant treatment of early breast cancer. These data suggest that both the steroidal (exemestane) and non-steroidal (anastrozole and letrozole) AIs appear to affect bone turnover. Conclusions regarding any clinically relevant differences between these agents are difficult to make, and further data are awaited from long-term adjuvant use of these three agents in ongoing clinical studies. Postmenopausal women are at increased risk of osteoporosis and fracture, and the increasing use of AIs in the adjuvant treatment of postmenopausal breast cancer patients will require appropriate consideration of fracture risk, with the use of anti-osteoporotic therapies, if necessary.

Antineoplastic Agents, Hormonal↗
PubMed2004

Endocrinology and hormone therapy in breast cancer: aromatase inhibitors versus antioestrogens.

Endocrine therapies act by either blocking or downregulating the oestrogen receptor or by reducing oestrogen concentrations around and within the cancer cell. In postmenopausal women, oestrogen suppression is achieved by inhibition of the enzyme aromatase by aromatase inhibitors (AIs). Modern AIs (anastrozole, letrozole and exemestane) are more potent than earlier ones and suppress oestradiol levels in plasma to virtually undetectable concentrations. Recent comparisons of AIs with the most widely used oestrogen receptor blocking drug tamoxifen indicate that, in general, AIs result in increased response rates and greater durations of response. Here, we summarize data supporting the difference between the two types of treatment and attempt to account for the underlying mechanisms that favour AIs.

Animals↗
PubMed2002

Evolving uses of hormonal agents for breast cancer therapy.

BACKGROUND: During the past decade, a number of new hormonal therapies (HTs) have been developed, including the selective estrogen receptor modulators (SERMs), aromatase inhibitors (AIs), and estrogen receptor (ER) antagonists. Their uses in breast cancer are continually evolving as new clinical trial results become available. Although tamoxifen, the most widely used HT for breast cancer, was originally approved for and used in the treatment of metastatic breast cancer (MBC), its effectiveness as MBC therapy led to its subsequent assessment and use as adjuvant and risk-reduction therapy for breast cancer. However, tamoxifen is not universally effective in these settings and is associated with infrequent known toxicities such as increased risk of thromboembolism and endometrial cancer; therefore, a search for more effective and more tolerable HTs has evolved. OBJECTIVE: This article reviews the data supporting the use of newer HTs as initial treatment of MBC and their potential use as adjuvant, neoadjuvant, and chemopreventive therapies. METHODS: Articles for inclusion in this manuscript were identified through the following searches, limited to English-language publications: MEDLINE (mid 1960s to January 2002), American Society of Oncology abstracts (1997-2001), and San Antonio Breast Cancer Symposium abstracts (2001 and 2002). The following search terms were used: breast cancer, breast cancer guidelines, hormonal therapies, tamoxifen, toremifine, letrozole, anastrozole, exemestane, megestrol acetate, fulvestrant, and ICI 182,780. RESULTS: Recent studies have focused on newer agents as initial and subsequent treatment of MBC, adjuvant or neoadjuvant treatments of breast cancer, and chemopreventive agents in both healthy women and women with a history of ductal carcinoma in situ (DCIS). Results of clinical trials comparing AIs with tamoxifen as first-line MBC treatment show that AIs are as effective as, or more effective than, tamoxifen and are associated with fewer serious adverse events. Tamoxifen remains the gold standard for adjuvant therapy. However, preliminary results of ongoing clinical trials comparing tamoxifen with anastrozole suggest that anastrozole may be the superior agent. Both tamoxifen and the AIs have been shown to be active in the neoadjuvant treatment of breast cancer. Trial results have shown that tamoxifen is effective for breast cancer prevention in patients at high risk of developing breast cancer but who are otherwise healthy, patients with a history of DCIS, and patients with lobular carcinoma in situ. CONCLUSIONS: Although tamoxifen has been the gold standard of HT for breast cancer, results of ongoing trials assessing the newer HTs as initial, neoadjuvant, adjuvant, and chemopreventive therapies may substantially change our current clinical practice patterns.

Anastrozole↗
PubMed1988

Autoimmune liver diseases.

Autoimmune-type chronic active hepatitis (AI-CAH) and primary biliary cirrhosis (PBC) are the two main autoimmune liver diseases. Although the etiologic agents of autoimmune liver diseases are unknown, a loss of tolerance against self antigens is regarded to be responsible for target cell destruction, that is, hepatocytes in AI-CAH and bile duct epithelia in PBC. AI-CAH is heterogeneous, and at least three different subgroups of AI-CAH can be distinguished by circulating autoantibodies including antinuclear antibodies (ANA), liver membrane autoantibodies (LMA), liver kidney microsomal antibodies (LKM), and antibodies to a soluble liver antigen (SLA). This has clinical relevance, because only autoimmune-type CAH seems to profit from immunosuppressive therapy. These serologic diagnostic markers may help to distinguish AI-CAH from CAH due to non-A, non-B virus infection. Antimitochondrial antibodies (AMA) and their PBC-specific subtypes characterize PBC, a chronic progressive cholestatic liver disease. Despite numerous therapeutic trials in the past, an effective medical treatment is not available. However, good results have been observed with orthotopic liver transplantation in end-stage PBC. This article has characterized autoimmune liver diseases, dealing with clinical, histologic, and immunopathologic aspects and concentrating on immune phenomena leading to their diagnosis. This has therapeutic consequences.

Autoantibodies↗
PubMedDate not supplied

General anesthesia and postoperative pain management in analgesic intolerant patients with/without asthma: is it safe?

BACKGROUND: Analgesic intolerance (AI) appears in approximately 1 % of the general population. The triad of bronchial asthma, nasal polyposis, and analgesic intolerance is called analgesic-induced asthma (AIA). These patients are frequently referred to adult allergy clinics for preoperative evaluation for possible analgesic cross reactivity and intolerance to anesthetic agents. OBJECTIVE: To determine allergic problems related to anesthesia and postoperative pain management in AI patients with and without asthma. METHODS: The medical records of 45 patients who had been diagnosed with AI between January 1991 and December 2002 in the adult allergy unit and who underwent surgery in the same hospital in the last 4 years were retrospectively analyzed. RESULTS: The mean age of the patients was 44.4 13.4 years and 30 (66.6 %) were female. Thirty-six (80 %) had AIA, 34 (75.6 %) had persistent allergic rhinitis and 21 (46.7 %) had nasal polyps. Fifty-one surgical procedures were performed in 45 patients, in whom ear, nose and throat surgery was the main procedure (64.7 %). Anesthesia was induced with propofol, fentanyl, and vecuronium and was maintained by sevoflurane or isoflurane. Fentanyl was used for early postoperative pain relief. No complications appeared in relation to anesthesia or early pain management except in a 44-year-old AIA woman who had a reaction in the postoperative period after receiving an inappropriate analgesic. CONCLUSIONS: None of the patients had anesthesia-related allergic problems. Atropine and diazepam in the premedication, propofol and fentanyl during induction, muscle relaxation facilitation by vecuronium, and sevoflurane or isoflurane for maintenance seem to be a safe general anesthetic choice for analgesic intolerant patients with and without asthma.

Adult↗
PubMed2003

Examining quality of life issues in relation to endocrine therapy for breast cancer.

With the development of highly effective, well-tolerated third-generation aromatase inhibitors (AIs), these drugs will probably play an increasingly important role in all phases of breast cancer treatment. As a result, the impact of such hormonal agents on patients' quality of life bears rigorous investigation. In a randomized, multicenter, single-blind cross-over study, the AIs letrozole and anastrozole were evaluated for quality of life, toxicity, and patient preference. A total of 72 patients were enrolled and were treated with each drug for a 4-week period, with a 1-week drug-free washout period before cross-over to the alternate agent. Assessments included the FACT-ES, toxicity, and patient preference. The FACT-ES is a validated questionnaire designed to measure quality of life of women with breast cancer who are being treated with endocrine therapies. Letrozole was superior to anastrozole with respect to both quality of life and toxicity evaluations. In addition, at the conclusion of the trial, reduced nausea, hot flashes, and abdominal discomfort caused almost twice as many patients to prefer to continue with letrozole therapy than with anastrozole. Data from this recent trial indicate that letrozole is better tolerated and provides better quality of life than anastrozole for women with metastatic breast cancer.

Anastrozole↗
PubMed2006

Aromatase inhibitors and bone loss.

The aromatase inhibitors (AIs) anastrozole (Arimidex), letrozole (Femara), and exemestane (Aromasin) are significantly more effective than the selective estrogen-receptor modulator (SERM) tamoxifen in preventing recurrence in estrogen receptor-positive early breast cancer. Aromatase inhibitors are likely to replace SERMs as first-line adjuvant therapy for many patients. However, AIs are associated with significantly more osteoporotic fractures and greater bone mineral loss. As antiresorptive agents, oral and intravenous bisphosphonates such as alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva), pamidronate (Aredia), and zoledronic acid (Zometa) have efficacy in preventing postmenopausal osteoporosis, cancer treatment-related bone loss, or skeletal complications of metastatic disease. Clinical practice guidelines recommend baseline and annual follow-up bone density monitoring for all patients initiating AI therapy. Bisphosphonate therapy should be prescribed for patients with osteoporosis (T score < -2.5) and considered on an individual basis for those with osteopenia (T score < -1). Modifiable lifestyle behaviors including adequate calcium and vitamin D intake, weight-bearing exercise, and smoking cessation should be addressed. Adverse events associated with bisphosphonates include gastrointestinal toxicity, renal toxicity, and osteonecrosis of the jaw. These safety concerns should be balanced with the potential of bisphosphonates to minimize or prevent the debilitating effects of AI-associated bone loss in patients with early, hormone receptor-positive breast cancer.

Aromatase Inhibitors↗