Table 1.
Variable | Value | Range | Data Source |
---|---|---|---|
Age at onset of ADT, y | 70 | 60–80 | 33 |
| |||
Progression of prostate cancer (per year), % | 14 | 11–17* | 33 |
Localized disease to rising PSA | |||
| |||
Rising PSA to noncastrate metastasis | 18 | 14–22* | 40 |
| |||
Noncastrate metastasis to castrate metastasis | 36 | 24–52 | 41 |
| |||
Castrate metastasis to prostate cancer death | 50 | 43–58 | 41 |
| |||
Mean BMD before ADT, g/cm2 | 0.7540 | 0.5915–0.8069 | 35 |
Rate of BMD loss (per year), g/cm2 | |||
| |||
No ADT | 0.0035 | 0.0026–0.0044 | 42 |
| |||
During ADT | 0.0188 | 0.0141–0.0235 | 43 |
Incidence of hip fractures per patient-year in patients with mean BMD, by age, % | 44 | ||
| |||
60–64 y | 0.055 | 0.028–0.083 | – |
| |||
65–69 y | 0.094 | 0.047–0.141 | – |
| |||
70–74 y | 0.195 | 0.098–0.293 | – |
| |||
75–79 y | 0.402 | 0.201–0.603 | – |
| |||
80–84 y | 0.922 | 0.461–1.383 | – |
| |||
85–100 y | 2.357 | 1.179–3.536 | – |
Relative risk for hip fractures per Z score, by age | 39 | ||
| |||
60–64 y | 3.07 | 2.42–3.89* | – |
| |||
65–69 y | 2.89 | 2.39–3.50* | – |
| |||
70–74 y | 2.78 | 2.39–3.23* | – |
| |||
75–79 y | 2.58 | 2.30–2.90* | – |
| |||
80–84 y | 2.28 | 2.09–2.50* | – |
| |||
85–100 y | 1.93 | 1.76–2.10* | – |
Relative risk for hip fractures due to a previous fracture, by age | 45 | ||
| |||
60–64 y | 3.16 | 1.88–5.32* | – |
| |||
65–69 y | 2.28 | 1.52–3.41* | – |
| |||
70–74 y | 1.90 | 1.37–2.65* | – |
| |||
75–79 y | 1.64 | 1.24–2.17* | – |
| |||
80–84 y | 1.41 | 1.12–1.78* | – |
| |||
85–100 y | 1.32 | 1.04–1.68* | – |
| |||
Bone loss prevented by alendronate, % | 100 | 50–100 | Assumed |
| |||
Adherence rate to alendronate therapy, % | 100 | 50–100 | 46 |
| |||
Incidence of upper gastrointestinal side effects of alendronate, % | 0.8 | 0–2 | 47 |
| |||
Background mortality per year, %† | 2.72 | 2.04–3.40 | 48 |
| |||
Relative risk for death within the first year after a hip fracture | 1.375 | 1–2 | 49, 50 |
| |||
Health state utility of prostate cancer | |||
Localized disease | 0.840 | 0.630–1.000 | 51 |
| |||
Rising PSA | 0.800 | 0.600–1.000 | Assumed |
| |||
Noncastrate metastasis | 0.440 | 0.330–0.550 | 51 |
| |||
Castrate metastasis | 0.130 | 0.098–0.163 | 51 |
| |||
Utility multiplier | |||
Hip fracture | |||
First year | 0.792 | 0.594–0.990 | 52–54 |
| |||
Subsequent years | 0.813 | 0.610–1.000 | 52–54 |
| |||
Upper gastrointestinal side effects of alendronate | 0.980 | 0.735–1.000 | 55 |
Cost, $ | |||
| |||
BMD test | 131 | 98–164 | 56 |
| |||
Alendronate (per year) | 600 | 300–900 | 57 |
| |||
Hip fracture, first year | 33 200 | 24 900–41 500 | 52, 54, 58 |
| |||
Hip fracture, subsequent years (per year) | 8100 | 6450–10 750 | 52, 54, 58 |
| |||
Upper gastrointestinal side effects of alendronate | 3000 | 2250–3750 | 56, 57 |
| |||
Discount rate, % | 3 | 0–6 | 32 |
ADT = androgen deprivation therapy; BMD = bone mineral density; PSA = prostate-specific antigen.
95% CI.
Variable was age-specific. Values shown are for persons aged 70 years.