[Osteoprotection in patients with non-metastatic hormone-sensitive prostate cancer (mHSPC) receiving androgen-deprivation therapy (ADT): Real-world data from Germany, presented by d-uo]. / Osteoprotektion beim nichtmetastasierten hormonsensitiven Prostatakarzinom (nmHSPC) unter androgendeprivativer Therapie (ADT): Aktuelle Daten aus Deutschland, vorgelegt von d-uo.

INTRODUCTION: Patients with prostate cancer often present with reduced bone mineral density. We herein present real-world data (RWD) regarding osteoprotection in patients with non-metastatic hormone-sensitive prostate cancer (nmHSPC) receiving androgen deprivation therapy (ADT) treated by German urologists in private practice. MATERIAL AND METHODS: This is a questionnaire-based study including members of d-uo ("Deutsche Uro-Onkologen", German uro-oncologists). Patients with nmHSPC between July 2019 and June 2020 were included. They were asked about start, type and duration of osteoprotection as well as supplementation with calcium and vitamin D. RESULTS: Between July 2019 and June 2020, a total of 3,692 patients with prostate cancer were seen at least once in one of the private practices of 15 urologists (all d-uo members). There were 844 patients (22.9%) with nmHSPC treated with ADT. Osteoprotection using denosumab or a bisphosphonate to prevent skeletal-related events (SRE) was applied in 183/844 patients (21.7%) with nmHSPC. In patients receiving osteoprotection, denosumab was chosen in 73.2% of patients and a bisphosphonate was chosen in 26.8% of patients. Supplementation with calcium and vitamin D was given in 84.7% of patients. CONCLUSION: Patients with nmHSPC received osteoprotection in 1/5 of patients. Of these, 3/4 received denosumab and 1/4 received a bisphosphonate. The majority of patients were additionally treated with calcium and vitamin D. In our study, osteoprotection in patients with nmHSPC was rather an exception.

[Osteoprotection in patients with bone metastatic castration-resistant prostate cancer (mCRPC): real-world data from Germany, presented by d-uo]. / Osteoprotektion beim ossär metastasierten kastrationsresistenten Prostatakarzinom (mCRPC): Aktuelle Daten aus Deutschland, vorgelegt von d-uo.

INTRODUCTION: Patients with bone metastasis due to prostate cancer often present allover reduced bone mineral density. Additionally, patients with bone metastatic castration-resistant prostate cancer (mCRPC) have a relevant risk for skeletal-related events (SRE). We herein present real-world data (RWD) regarding osteoprotection in mCRPC patients with bone metastasis treated by German urologists in private practice. MATERIAL AND METHODS: This is a questionnaire-based study including members of d-uo ("Deutsche Uro-Onkologen", German uro-oncologists). All patients with histologically confirmed prostate cancer seen at least once in the surveyed urology practice between July 2019 and June 2020 were included. Questions included start, type and duration of osteoprotection as well as supplementation with calcium and vitamin D. RESULTS: Between July 2019 and June 2020, a total of 3,692 patients with prostate cancer were seen at least once in 15 urology practices. There were 410 mCRPC patients (11.1%) with bone metastasis. Osteoprotection with denosumab or a bisphosphonate to prevent SRE was applied in 274/410 mCRPC patients (66.4%) with bone metastasis. In patients receiving osteoprotection, denosumab was chosen for 67.9% of patients and a bisphosphonate was chosen for 32.1%. Supplementation with calcium and vitamin D was performed in 93.4% of the patients. The median duration of treatment was 25.3 months for denosumab compared with 39.6 months for bisphosphonates. CONCLUSIONS: Patients with mCRPC with bone metastasis received osteoprotection in 2/3 of cases. Of these, 2/3 received denosumab and 1/3 received a bisphosphonate. The majority of patients were also treated with calcium and vitamin D. According to guideline recommendations regarding osteoprotection in mCRPC patients with bone metastasis, our RWD data showed some lack of guideline adherence.

Spiral stent versus standard stent in patients with midsize renal stones treated with extracorporeal shock wave lithotripsy: which stent works better? A prospective randomized trial.

PURPOSE: It has been proposed that stone fragment clearance with a new spiral Double-J stent (Medical Engineering Corp., New York, New York) is faster than with a standard Double-J stent. Therefore, we evaluated stent insertion, peri-interventional complications, as well as stone clearance in patients with midsize kidney stones treated with extracorporeal shock wave lithotripsy (3,500 shock waves) in a prospective randomized trial. MATERIALS AND METHODS: A total of 32 patients were randomized for preoperative insertion of a spiral stent (16) or a standard stent (16). Stone volume was measured from an abdominal plain film. Stent inserting time and stent handling problems, as well as perioperative and postoperative complications were evaluated. Clearance of stone fragments was analyzed by abdominal plain films and ultrasound on day 1, and at the end of weeks 1, 2 and 6 after treatment or until stone fragments were completely cleared. RESULTS: Median stone volume was 1.8 ccm (range 0.4 to 5.2) in the spiral stent group and 1.3 ccm (range 0.4 to 2.6) in the standard stent group (p = 0.08). Median stent inserting time was 21 minutes (range 10 to 60) in the spiral stent and 18 minutes (range 5 to 45) in the standard stent group (p = 0.94). Inserting difficulties occurred in 6 of 16 (38%) patients with spiral stents and in none with standard stents (p = 0.005). Spontaneous stent displacement occurred in 4 of 16 patients in the spiral stent group and did not occur in the standard stent group (p = 0.03). The percentage of stone-free patients 1 day, and 1, 2 and 6 weeks after treatment was 0%, 13%, 44% and 81% in the spiral stent group and 6%, 19%, 50% and 88% (p = 0.64) in the standard stent group, respectively. CONCLUSIONS: Spiral stents are more difficult to insert, spontaneously dislocate more often and have no advantage in overall stone clearance compared with standard stents.

The neurokinin-2 receptor is not involved in the sensitization of primary afferents of the rat knee joint.

Using electrophysiological methods, we aimed in the present study to determine whether the NK(2) receptor is involved in the sensitization of articular afferents of the rat. Impulse activity from 27 single fine nerve fibres innervating knee joints was recorded during non-noxious and noxious joint rotations. Close intraarterial application of the NK(2) receptor agonist [beta-Ala(8)]NKA(4-10) at doses of 0.2-200 nmol did not sensitize the afferents from normal knee joints to mechanical stimuli whereas the application of substance P (20 nmol) increased their mechanosensitivity. These data further support the hypothesis that the NK(2) receptor is not involved in the sensitization of primary afferents in normal knee joints to mechanical stimuli.