DISAMPING KANAN INI.............
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penelitian
menunjukkan ,Bifosfonat
untuk osteoporosis tidak terkait dengan risiko kanker payudara berkurang
Sebuah analisis
dari data uji klinis acak trial menemukan bahwa 3-4 tahun
pengobatan dengan Bifosfonat untuk meningkatkan kepadatan tulang tidak
dihubungkan dengan penurunan risiko kanker payudara invasif pascamenopause.
Beberapa studi telah menyarankan bahwa Bifosfonat, yang umumnya digunakan untuk
mengobati osteoporosis, mungkin memiliki sifat antitumor dan antimetastatic.
Beberapa survei telah menyarankan Bifosfonat dapat melindungi wanita dari
kanker payudara..................
Bisphosphonates for osteoporosis not associated with reduced breast
cancer risk, study suggests
Date:
August 11,
2014
Source:
The JAMA Network Journals
Summary:
An analysis of data from two randomized clinical
trials finds that 3-4 years of treatment with bisphosphonates to improve bone
density is not linked to reduced risk of invasive postmenopausal breast cancer.
Some studies have suggested that bisphosphonates, which are commonly used to
treat osteoporosis, may have antitumor and antimetastatic properties. Some
observational studies have suggested bisphosphonates may protect women from
breast cancer.
.....................
An analysis of data from two randomized clinical trials
finds that three to four years of treatment with bisphosphonates to improve bone
density is not linked to reduced risk of invasive postmenopausal breast cancer.
Some studies
have suggested that bisphosphonates, which are commonly used to treat
osteoporosis, may have antitumor and antimetastatic properties. Some
observational studies have suggested bisphosphonates may protect women from
breast cancer.
The authors
analyzed the relationship of postmenopausal breast cancer and bisphosphonate
use by examining data from two randomized, double-blind, placebo-controlled
trials. The Fracture Intervention Trial (FIT) randomly assigned 6,459 women
(ages 55 to 81 years) to alendronate or placebo with an average follow-up of
3.8 years. The Health Outcomes and Reduced Incidence with Zoledronic Acid Once
Yearly-Pivotal Fracture Trial (HORIZON-PFT) randomly assigned 7,765 women (ages
65 to 89 years) to annual intravenous zoledronic acid or placebo with an
average follow-up of 2.8 years. The authors compared rates of breast cancer in
the bisphosphonate treatment groups to the placebo groups.
There was no
significant difference in breast cancer rates between the bisphosphonate and
placebo groups. In FIT, the breast cancer rate was 1.5 percent in the placebo
group and 1.8 percent in the alendronate group. In HORIZON-PFT the rate was 0.8
percent in the placebo group and 0.9 percent in the zoledronic acid group.
There also was no significant difference when data from the two trials were
combined.
"These
data provide evidence that three to four years of treatment with
bisphosphonate, alendronate or zoledronic acid, therapy does not reduce the
risk of incident breast cancer in postmenopausal women. The discrepancy between
our results and the reports of associations in observational studies may be an
example of indication bias and illustrates the limitation and hazard of drawing
conclusions about treatment effects from observational studies (even those that
are very well done) and emphasizes the value of confirming such associations in
randomized trials. The effect of bisphosphonate treatment on breast cancer risk
in nonosteoporotic populations should be investigated in other randomized
trials."
In a related
editor's note, Joseph S. Ross, M.D., M.H.S., a JAMA Internal Medicine
associate editor, writes: "Whereas these findings highlight why it is so
important for new therapies to be evaluated using RCTs (randomized clinical
trials), they also reinforce the importance of assessing the methodological
rigor of observational studies before interpreting real-world effects."
"Just
as we closely scrutinize RCT design, so must we understand the quality and
statistical power of the data used for observational studies, how participants
were identified, the duration of follow-up, the end points examined, and the
analytical strategy used. Observational studies are particularly valuable for
clinical situations unlikely to be tested using RCTs, and many provide valid
and reliable real-world evidence," Ross continues.
"Thus,
whereas we all can remember examples of when RCTs and observational studies
differed, less memorable are the even more numerous examples in which results
were consistent. In the end, we should be open to all types of evidence and
rely on rigorous clinical science to guide practice," Ross concludes.
Story
Source:
The above
story is based on materials provided by The JAMA Network Journals. Note: Materials may be edited
for content and length.
Journal
Reference:
- Trisha F. Hue, Steven R. Cummings, Jane A. Cauley, Douglas C. Bauer, Kristine E. Ensrud, Elizabeth Barrett-Connor, Dennis M. Black. Effect of Bisphosphonate Use on Risk of Postmenopausal Breast Cancer. JAMA Internal Medicine, 2014; DOI: 10.1001/jamainternmed.2014.3634
