Date of Award
Spring 2026
Document Type
Scholarly Project
Degree Name
Master of Physician Assistant Studies (MPAS)
Department
Physician Assistant Studies
First Advisor
Kristen Carr
Second Advisor
Mindy Staveteig
Keywords
androgen depravation therapy, denosumab, bisphosphonates, castration resistant prostate cancer, Bone mineral density, DEXA, bone turnover markers
Abstract
Prostate cancer is among the most prevalent solid organ malignancies among men. The most widely accepted and clinically proven form of treatment for prostate cancer is androgen deprivation therapy. ADT presents a new problem in it's targeted population, by inhibiting testosterone and estradiol to slow or stop the growth of new prostate cancer, the androgens osteoprotective elements are eliminated. The purpose of this literature review is to explore the effectiveness of bisphosphonates verses RANKL inhibitors at maintaining bone mineral density and decreasing future fracture risk in men undergoing ADT. The electronic databases PubMed and Embase were searched, and the 5 studies chosen for review were double-blind randomized trials with substantial patient populations. Key terms were osteoporosis, male, testosterone, replacement, therapy, bisphosphonate, denosumab, and fracture. Current research does not have a definitive answer for which patient populations should receive which osteo protective agents based on current guidelines. Future research should focus on further head-to-head comparisons between leading candidates of bisphosphonates and RANKL inhibitors as well as emerging alternatives such as androgen receptor pathway inhibitors and selective estrogen modulators.
Recommended Citation
Wosick, Miles, "Comparing RANKL Inhibitors to Bisphosphonates in Men on Androgen Deprivation Therapy" (2026). Physician Assistant Scholarly Project Papers. 250.
https://commons.und.edu/pas-grad-papers/250