UroToday- Well recognized potential side effects of androgen deprivation therapy include anemia, decreased libido, the metabolic syndrome, memory loss, weight gain, hot flashes, and osteoporosis. Since periodontal disease results in absorption of alveolar bone, some have suggested that generalized bone mineral loss may exacerbate periodontal disease. The relationship between androgen deprivation therapy and periodontal disease has not been studied.

In the March issue of the Journal of Urology, Famili and colleagues from the University of Pittsburg compared the incidence of periodontal disease in men with prostate cancer treated with or without androgen deprivation therapy.

A total of 81 men with prostate cancer and a mean age of 68.5 years enrolled in the study. Sixty-eight men with prostate cancer underwent periodontal examinations, including 27 men not receiving androgen deprivation (non-ADT) and 41 men on androgen deprivation therapy (ADT). There was no difference between groups with regards to race, history of smoking, previous dental visits, missing teeth, denture use, dental hygiene, or previous periodontal disease. Of these 68 men, 81% of men receiving androgen deprivation therapy were found to have periodontal disease, compared with 3.8% in the non-ADT group (Hazard ratio = 3.33, 95% CI 1.07 to 10.3, p < 0.038). This three-fold increase in periodontal disease was significant even after adjusting for race, history of smoking, or previous periodontal treatment. Interestingly, bone mineral density was not statistically significantly different between the ADT and non-ADT groups.

This study with a small sample size is the first to suggest that men with prostate cancer receiving androgen deprivation therapy exhibit a three-fold higher risk of periodontal disease compared with controls. While the authors suggest that alveolar bone osteoporosis may account for this effect, no differences were found in bone mineral density between groups. These data should be confirmed in a larger cohort of patients to further clarify its etiology and potentially identify measures of prevention for patients embarking on androgen deprivation therapy.

Famili P, Cauley JA, Greenspan SL

J Urol 2007 Mar; 177(3):921-4.
Reviewed by UroToday Contributing Editor Ricardo F. SГЎnchez-Ortiz, MD

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