ADT for prostate cancer may increase risk for diabetes and CVD
MedWire News: Results show that prostate cancer patients treated with androgen deprivation therapy (ADT) may have an increased risk for developing Type 2 diabetes and cardiovascular disease (CVD).
Nancy Keating (Harvard Medical School, Boston, Massachusetts, USA) and colleagues carried out an observational study of 37,443 men diagnosed with prostate cancer between January 2001 and December 2004 and who were followed-up until December 2005.
The researchers assessed whether ADT with gonadotropin-releasing hormone (GnRH) agonists, oral anti-androgens, the combination of the two (ie, combined androgen blockade), or orchiectomy was associated with incident Type 2 diabetes or CVD (coronary heart disease [CHD], myocardial infarction [MI], sudden cardiac death, or stroke) during follow-up.
Overall, 39% of the cohort was treated with ADT. The team found that use of GnRH agonists was associated with a significant 28% increased relative risk for incident Type 2 diabetes. This amounted to 159.4 versus 87.5 events per 1000 person-years for GnRH agonist treatment and no ADT, respectively.
In addition, the patients treated with GnRH agonists had a 19%, 28%, 35%, and 36% increased relative risk for CHD, MI, sudden cardiac death, and stroke, respectively.
Combined androgen blockade and orchiectomy were also significantly associated with an increased risk for CHD and MI, but not diabetes, while oral anti-androgen monotherapy was not associated with diabetes or CVD risk.
“Additional research is needed to understand the effects of GnRH agonists for clinical settings where benefits have not yet been established, to identify populations of men at highest risk of complications associated with GnRH agonists, and to investigate strategies to prevent treatment-related morbidity,” conclude the authors in the Journal of the National Cancer Institute.
“Nevertheless, patients and physicians considering initiation of GnRH agonist treatment for local or regional prostate cancer should factor the potential increased risks of diabetes and cardiovascular disease as they make treatment decisions.”
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By Helen Albert