Abiraterone Acetate Plus Prednisone Induced Bilateral Avascular Necrosis of the Femoral Head
Year: 2026
Type: article
Study design: Case Report
Abstract: Abiraterone acetate (AA) is an inhibitor of cytochrome P450c17 that suppresses androgen synthesis from steroid precursors.Prednisone (P) is coadministered with AA to correct the glucocorticoid deficiency resulting from AA-induced alterations in steroid synthesis and to suppress excessive mineralocorticoid effects.We report bilateral avascular necrosis of the femoral head in a patient treated with AA+P; this condition is usually seen with long-term, high-dose glucocorticoid use.A 54-year-old male patient was diagnosed with castration-resistant metastatic prostatic adenocarcinoma (Gleason score 4+5).Following progression on androgen deprivation therapy+docetaxel, AA+P treatment was initiated.During this treatment period, the patient was in remission for thirty months; later, he developed bilateral avascular necrosis of the femoral heads and was referred to orthopaedics.Core decompression surgery was performed on both femoral necks due to avascular necrosis.Management and outcome: AA+P treatment was not discontinued because of the highly successful results in treating prostate cancer, and the patient remains in remission while continuing this treatment.AA+P is a treatment for prostate cancer that inhibits androgen synthesis.Although P is administered in low doses to prevent abiraterone-induced reductions in glucocorticoid levels, serious glucocorticoid side effects may, in rare cases, develop in these patients.To our knowledge, this is the first report of such a side effect in the literature.
Source: Journal of Oncological Sciences
Institution: Ankara Bilkent City Hospital
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7125383367
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