Sie sind bereits registriert?
Loggen Sie sich mit Ihrem Universimed-Benutzerkonto ein:
Sie sind noch nicht registriert?
Registrieren Sie sich jetzt kostenlos auf universimed.com und erhalten Sie Zugang zu allen Artikeln, bewerten Sie Inhalte und speichern Sie interessante Beiträge in Ihrem persönlichen Bereich zum späteren Lesen. Ihre Registrierung ist für alle Unversimed-Portale gültig. (inkl. allgemeineplus.at & med-Diplom.at)
Do Abiraterone or Enzalutamide Increase Risk for Metabolic and Cardiovascular Events?
Although androgen deprivation therapy (ADT) is the cornerstone for the systemic management of advanced prostate cancer, there is an associated elevated risk for both metabolic syndrome and major cardiovascular events. Abiraterone and enzalutamide are widely used in advanced prostate cancer based on evidence of survival benefit. To examine their safety in routine practice, investigators assessed the occurrence of metabolic and cardiovascular events in a random sample of 20% of Medicare beneficiaries from 2010–2017.
The primary outcome was a composite measure of major metabolic and cardiac events, defined as an emergency room visit or hospitalization associated with a primary diagnosis of diabetes, hypertension, or cardiovascular disease. A secondary endpoint, minor metabolic or cardiac events, was defined as an outpatient visit associated with those same diagnoses. For both endpoints, individuals were excluded from the analysis if they had the relevant diagnostic codes within the prior 12 months.
Both abiraterone and enzalutamide were associated with increased risk of major metabolic or cardiovascular events (hazard ratios, 1.77 and 1.22, respectively). Patients treated with abiraterone had 1 additional major cardiovascular event for each 29 patients treated. Abiraterone was associated with an increased risk of minor events, whereas enzalutamide was not. In analyses of individual minor events, abiraterone was associated with new diagnosis of diabetes (HR, 1.37), while enzalutamide was associated with reduced risk of diabetes (HR, 0.66).
Recent level 1 evidence has expanded the indications for abiraterone and enzalutamide beyond metastatic castration-resistant prostate cancer to use of either agent in addition to ADT in metastatic castration-sensitive prostate cancer and, for enzalutamide, to use in non-metastatic castration-resistant disease. As use of these agents expands, the potential increase in non-prostate cancer morbidity and mortality must be included in risk/benefit discussion.
Lai LY et al.
Title: Risk of metabolic and cardiovascular adverse events with abiraterone or enzalutamide among men with advanced prostate cancer.
Source: J Natl Cancer Inst 2022 Aug 8; [e-pub]. (Abstract/FREE Full Text)