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The Skeletal Effects of Gonadotropin-Releasing Hormone Antagonists: A Concise Review

Nur-Vaizura Mohamad1, Soelaiman Ima-Nirwana1, Kok-Yong Chin1

  • 1Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.

Endocrine, Metabolic & Immune Disorders Drug Targets
|December 17, 2020
PubMed

Insights

Gonadotropin-releasing hormone (GnRH) antagonists effectively treat hormone-dependent conditions but can cause significant bone loss. Early preventive measures are crucial to mitigate osteoporosis and fractures in patients.

Area of Science:

  • Endocrinology
  • Oncology
  • Bone Biology

Background:

  • Prolonged Gonadotropin-Releasing Hormone (GnRH) agonist use is linked to bone loss in prostate cancer patients.
  • Skeletal effects of GnRH antagonists require further investigation.
  • GnRH antagonists are used for advanced prostate cancer and endometriosis.

Purpose of the Study:

  • To review the effects of GnRH antagonists on bone health.
  • To evaluate the impact of GnRH antagonists on bone microstructure and density.

Main Methods:

  • Review of animal studies on GnRH antagonist effects on bone.
  • Analysis of human clinical trials examining bone mineral density changes.
  • Assessment of osteoporosis and fracture risk in GnRH antagonist users.

Main Results:

  • GnRH antagonists suppress gonadotropins and sex hormones, leading to accelerated bone loss.
  • Animal studies show GnRH antagonist treatment deteriorates bone microstructure.
  • Human trials reveal significant bone loss at the spine, hip, and femur.

Conclusions:

  • GnRH antagonists can cause substantial bone loss, increasing osteoporosis and fracture risk.
  • Bone health monitoring and preventive strategies are essential for patients using GnRH antagonists.
  • Addressing bone loss is critical for improving patient quality of life and reducing morbidity.
Keywords:
Bone mineral densityestrogenfractureosteoporosissex hormonestestosterone.

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