Fracture after androgen deprivation therapy among men with a high baseline risk of skeletal complications

Receipt of androgen deprivation therapy (ADT) has been associated with an increased risk of skeletal‐associated complications, such as a decrease in bone mineral density and an increase in fracture risk. Many men with pre‐existing health conditions receive ADT as their primary treatment because they are considered to be inappropriate candidates for attempted curative treatments. However, several chronic health conditions, such as diabetes, rheumatoid disease and chronic liver disease, are strong predictors for osteoporosis and fractures. We undertook the present study aiming to quantify the impact of treating men with ADT who carry known risk factors for skeletal complications. Among these high‐risk men, more than 58% develop at least one fracture after ADT within the 12 years of follow‐up. Men who sustained a fracture within 48 months experienced an almost 40% higher risk of mortality than those who did not. Our findings suggest that treating men with a high fracture risk at baseline with long‐term ADT may have serious adverse consequences.