{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:45:08Z","timestamp":1791895508744,"version":"4.3.4"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bone health agents (BHAs) prevent symptomatic skeletal events (SSEs) in bone-metastatic castration-resistant prostate cancer (mCRPC). We evaluated contemporary BHA utilization and SSE incidence (2016\u20132021) compared with a historical cohort (2010\u20132015), during a period of substantial changes in mCRPC treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from 2,115 CRPC patients with bone metastases (Dutch CAPRI-3 registry) were compared to the CAPRI-2 cohort (N\u2009=\u20091,923). Clinical evolution and SSE outcomes were analysed in 1,792 patients receiving life-prolonging drugs (LPDs), categorized by BHA timing relative to the first LPD: no BHA, early BHA (\u22644 weeks), or late BHA (&amp;gt;4 weeks).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to the historical cohort (2010-2015), patients in the 2016-2021 cohort were older (75 vs. 73 years), frailer (Charlson Comorbidity Index \u22655: 44% vs. 13%), and received LPDs in metastatic castration-sensitive setting more frequently (35% vs. 0%). BHA utilization dropped from 60% to 28%, with only 8% receiving guideline-recommended timing of BHA initiation. However, the overall SSE incidence declined from 0.26 to 0.21 events\/patient-year between cohorts. Early BHA initiation was predominantly reserved for high-risk disease; this group experienced the highest SSE density (0.29) and shortest median SSE-free survival (8.7 vs. 14.6 months; p\u2009&amp;lt;\u20090.001) compared with the group without BHA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>As the mCRPC population becomes older and more pre-treated, guideline-recommended BHA timing remains limited. Although overall skeletal morbidity declined, the high SSE density in high-risk patients underscores the need to identify those patients most likely to benefit from early bone protection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djag385","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:27:53Z","timestamp":1791804473000},"source":"Crossref","is-referenced-by-count":0,"title":["Trends in bone health agent use and skeletal events in metastatic castration-resistant prostate cancer"],"prefix":"10.1093","author":[{"given":"Kim J M","family":"van der Velden","sequence":"first","affiliation":[{"name":"University Medical Center Groningen Department of Urology, , Groningen (UMCG), The","place":["Netherlands"]},{"name":"Radboud University Medical Center Department of Urology, , Nijmegen,","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dianne","family":"Bosch","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center Department of Urology, , Nijmegen,","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anneloes M","family":"van den Wildenberg","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center Department of Urology, , Nijmegen,","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9 M","family":"Bergman","sequence":"additional","affiliation":[{"name":"Netherlands Cancer Institute (NKI) Prostate Cancer Center, , Amsterdam, the","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten J","family":"van der Doelen","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center Department of Urology, , Nijmegen,","place":["Netherlands"]},{"name":"Zuyderland Medical Center Department of Urology, , Heerlen,","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reindert J A","family":"van Moorselaar","sequence":"additional","affiliation":[{"name":"Amsterdam University Medical Center Department of Urology, , Amsterdam, the","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diederik M","family":"Somford","sequence":"additional","affiliation":[{"name":"Canisius Wilhelmina Hospital (CWZ) Department of Urology, , Nijmegen, the","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Metin","family":"Tascilar","sequence":"additional","affiliation":[{"name":"Isala Hospital Department of Medical Oncology, , Zwolle, the","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carin A","family":"Uyl\u2013de Groot","sequence":"additional","affiliation":[{"name":"Erasmus University Rotterdam Erasmus School of Health Policy and Management, , Rotterdam, The","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge M","family":"van Oort","sequence":"additional","affiliation":[{"name":"University Medical Center Groningen Department of Urology, , Groningen (UMCG), The","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malou C P","family":"Kuppen","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Centre+ Department of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, , Maastricht, The","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,13]]},"container-title":["JNCI: Journal of the National Cancer Institute"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jnci\/advance-article-pdf\/doi\/10.1093\/jnci\/djag385\/71904241\/djag385.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jnci\/advance-article-pdf\/doi\/10.1093\/jnci\/djag385\/71904241\/djag385.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:47:09Z","timestamp":1791892029000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jnci\/advance-article\/doi\/10.1093\/jnci\/djag385\/8913753"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,13]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/jnci\/djag385","relation":{},"ISSN":["0027-8874","1460-2105"],"issn-type":[{"value":"0027-8874","type":"print"},{"value":"1460-2105","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,13]]},"article-number":"djag385"}}