Table 3.

Antiresorptives in men with prostate cancer

Prevention of CTIBL in men with prostate cancer treated with androgen deprivation therapy		Prevention of metastases and improving diseases outcomes in men with prostate cancer
When? (according to different expert groups)	Which agents are recommended?	Which agents?	Level of evidence and grade of recommendationa
T-score < −2.0 or ≥2 clinical risk factors for fracturesb[38] T-score ≤ −2.5 [46, 54] 10-year fracture risk (FRAX) [43, 46] ≥3% for hip fracture ≥20% for major fracture	BP prevent bone loss: I, B [38], but various treatment schemes Alendronate 70 mg p.o. weekly [38] Risedronate 35 mg p.o. weekly [38] Zoledronic acid 4 mg i.v. q3mo [55] Zoledronic acid 4 mg i.v. q6mo [38] Zoledronic acid 5 mg i.v. q12mo [43] Pamidronate 90 mg i.v. q3mo [38]  Denosumab prevents bone loss & vertebral fractures: I, B [38] Denosumab 60 mg s.c. q6mo [38, 53]	Denosumab 120 mg s.c. monthly [38]	Denosumab delays bone metastasis in castrate-resistant prostate cancer, but no effect on overall survival: I, B [38]

^aMarked in bold: Level of evidence (I-V) - Grade of recommendation (A-E)

^bClinical risk factors include: age >65 years, T-score <1.5, smoking (current or history of), BMI < 24 kg/m², family history of hip fracture, personal history of fragility fracture above age 50, oral glucocorticoid use for >6 months [38]