Review of Cardiovascular Risk of Androgen Deprivation Therapy and the Influence of Race in Men with Prostate Cancer

Fradin, James; Kim, Felix J.; Lu-Yao, Grace L.; Storozynsky, Eugene; Kelly, William Kevin

doi:10.3390/cancers15082316

Cited by 9 publications

(1 citation statement)

References 78 publications

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“…Prostate cancer is the leading cause of cancer-related mortality, and its treatment often involves ADT such as AA and ENZ [3]. While these therapies have proven effective in managing mCRPC [3,28] they come with a risk of adverse cardiovascular events [14,28,29]. Furthermore, the available literature on the treatment of metastatic prostate cancer with AA and ENZ predominantly comprises clinical trials, with a limited representation of real-world data.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular events among patients with prostate cancer treated with abiraterone and enzalutamide

Baser,

Samayoa,

Dwivedi

et al. 2024

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Background and purpose: There is growing concern about the adverse metabolic and cardiovascular effects of abiraterone acetate (AA) and enzalutamide (ENZ), two standard hormonal therapies for prostate cancer. We analysed the risk of cardiovascular adverse events among patients treated with AA and ENZ. Patients and methods: We used Kythera Medicare data from January 2019 to June 2023 to identify patients with at least one pharmacy claim for AA or ENZ. The index date was the first prescription claim date. Patients were required to have 1 year of data pre- and post-index date. New users excluded those with prior AA or ENZ claims and pre-existing cardiovascular comorbidities. Demographic and clinical variables, including age, socioeconomic status (SES), comorbidity score, prostate-specific comorbidities, and healthcare costs, were analysed . Propensity score matching was employed for risk adjustment. Results: Of the 8,929 and 8,624 patients in the AA and ENZ cohorts, respectively, 7,647 were matched after adjusting for age, sociodemographic, and clinical factors. Between the matched cohorts (15.54% vs. 14.83%, p < 0.05), there were no statistically significant differences in any cardiovascular event after adjusting for these factors. The most common cardiovascular event in both cohorts was heart failure (5.20% vs. 4.49%), followed by atrial fibrillation (4.42% vs. 3.60%) and hypotension (2.93% vs. 2.48%). Interpretation: This study provides real-world evidence of the cardiovascular risk of AA and ENZ that may not appear in clinical trial settings. Adjusting for age, baseline comorbidities, and SES, the likelihood of a cardiovascular event did not differ between treatment groups.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular events among patients with prostate cancer treated with abiraterone and enzalutamide

Baser,

Samayoa,

Dwivedi

et al. 2024

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Impact of comorbidities on prostate cancer‐specific mortality: A population‐based cohort study

Tiruye,

Roder,

FitzGerald

et al. 2024

The Prostate

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AimTo assess the impact of comorbidities on prostate cancer mortality.MethodsWe studied 15,695 South Australian men diagnosed with prostate cancer between 2003 and 2019 from state‐wide administrative linked data sets. Comorbidity was measured 1‐year before prostate cancer diagnosis using Rx‐Risk, a medication‐based comorbidity index. Flexible parametric competing risk regression was used to estimate the independent association between comorbidities and prostate cancer‐specific mortality. Specific common comorbidities within Rx‐Risk (cardiac disorders, diabetes, chronic airway diseases, depression and anxiety, thrombosis, and pain) were also assessed to determine their association with mortality. All models were adjusted for sociodemographic variables, tumor characteristics, and treatment type.ResultsProstate cancer‐specific mortality was higher for patients with a Rx‐Risk score ≥3 versus 0 (adjusted sub‐hazard ratio (sHR) 1.34, 95% CI: 1.15–1.56). Lower comorbidity scores (Rx‐Risk score 2 vs. 0 and Rx‐Risk score 1 vs. 0) were not significantly associated with prostate cancer‐specific mortality. Men who were using medications for cardiac disorders (sHR 1.31, 95% CI: 1.13–1.52), chronic airway disease (sHR 1.20, 95% CI: 1.01–1.44), depression and anxiety (sHR 1.17, 95% CI: 1.02–1.35), and thrombosis (sHR 1.21, 95% CI: 1.04–1.42) were at increased risk of dying from prostate cancer compared with men not on those medications. Use of medications for diabetes and chronic pain were not associated with prostate cancer‐specific mortality. All Rx‐Risk score categories and the specific comorbidities were also associated with increased risk of all‐cause mortality.ConclusionThe findings showed that ≥3 comorbid conditions and specific comorbidities including cardiac disease, chronic airway disease, depression and anxiety, and thrombosis were associated with poor prostate cancer‐specific survival. Appropriate management of these comorbidities may help to improve survival in prostate cancer patients.

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Patient Preferences for Attributes of Androgen Deprivation Therapies in Prostate Cancer: A Discrete Choice Experiment with Latent Class Analysis

Hauber,

Hong,

Hunsche

et al. 2024

Adv Ther

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Introduction: Medical androgen deprivation therapy (ADT) options have expanded for patients with advanced prostate cancer (PC). Historically, ADT was primarily available in longacting injectable formulations. In 2020, the first oral formulation was US Food and Drug Administration-approved for adults with advanced PC. This study's aim was to assess patient preferences for attributes of medical ADT, including mode

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Review of Cardiovascular Risk of Androgen Deprivation Therapy and the Influence of Race in Men with Prostate Cancer

Cited by 9 publications

References 78 publications

Cardiovascular events among patients with prostate cancer treated with abiraterone and enzalutamide

Cardiovascular events among patients with prostate cancer treated with abiraterone and enzalutamide

Impact of comorbidities on prostate cancer‐specific mortality: A population‐based cohort study

Patient Preferences for Attributes of Androgen Deprivation Therapies in Prostate Cancer: A Discrete Choice Experiment with Latent Class Analysis

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