Approach in aromatase inhibitors - Induced osteoporosis: results from an Italian multicenter observational study

Silvia Migliaccio, Alessandro De Sire, Chiara Marocco, Rachele Fornari, Marco Paoletta, Emanuela A. Greco, Inbal Dona Amar, Antimo Moretti, Stefano Ronzoni, Francesca Gimigliano, Vincenzo Vinicola, Fiorella Chiacchiararelli, Francesco Guadalascara, Renato Pastore, Paolo Falaschi, Giovanni Minisola, Orazio Falla, Domenico Castellitto, Andrea Lenzi, Paola VillaGiovanni Iolascon

Research output: Contribution to journalArticle


Background. Breast cancer (BC) is one of the most frequent cancer worldwide with about 25% of new cases in female population. Aromatase inhibitors (AIs) are recommended by National and International guidelines as treatment for women affected by BC estrogen receptor-positive tumors. However, these drugs, blocking the enzyme converting androgens into estrogens, might result in reduction of bone mineral density (BMD). Although since 2012 the use of antiresorptive drugs was recommended for AIs-associated bone loss, only few patients received this treatment in real practice. Therefore, we aimed to assess the appropriateness of the management of AIs-associated bone loss by oncologists and bone specialists in BC women. Methods. In this Italian multicenter retrospective study, we included women affected by BC referred to 11 Italian Centers for Osteoporosis from two Italian regions (Lazio and Campania) in a 2 year-period (from March 2013 to February 2015). We evaluated the difference in terms of appropriateness of bone health management according to the 2012 European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO), Position Paper between oncologists and bone specialists (endocrinologists, physiatrists, rheumatologists, internists, geriatrists, and gynecologists). Results. We included 300 women affected by BC, mean aged 63.26 ± 9.48 years, 182 (60.67%) treated with anastrozole, 87 (29.00%) with letrozole, and 31 (10.33%) with exemestane. Anti-osteoporotic drugs were prescribed in 87 patients (29.0%) by oncologists and in 216 patients (72.0%) by bone specialists. We found that only 44.67% were appropriately managed in terms of bone health by the oncologists, compared to 71.17% of cases by bone specialists. Conclusions. This Italian multicenter retrospective study showed a more appropriate management of AIs-induced osteoporosis by bone specialists, demonstrating a key role of these physicians in the bone health management of BC patients.

Original languageEnglish
Pages (from-to)334-339
Number of pages6
JournalClinical Cases in Mineral and Bone Metabolism
Issue number3
Publication statusPublished - Sep 1 2018



  • Anti-osteoporotic treatment
  • Aromatase inhibitors
  • Breast cancer
  • Oncology
  • Osteoporosis

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Migliaccio, S., De Sire, A., Marocco, C., Fornari, R., Paoletta, M., Greco, E. A., Amar, I. D., Moretti, A., Ronzoni, S., Gimigliano, F., Vinicola, V., Chiacchiararelli, F., Guadalascara, F., Pastore, R., Falaschi, P., Minisola, G., Falla, O., Castellitto, D., Lenzi, A., ... Iolascon, G. (2018). Approach in aromatase inhibitors - Induced osteoporosis: results from an Italian multicenter observational study. Clinical Cases in Mineral and Bone Metabolism, 15(3), 334-339.