Clinicians believe that there is an association between the risk of cardiovascular disease (CVD) and the duration and type of androgen-deprivation therapy (ADT) in men with prostate cancer.
Researchers took data from 2006 to 2012 on filled drug prescriptions from the Swedish national health care registers. A cohort of 41,362 men with prostate cancer who were on ADT was compared with an age-matched prostate cancer free cohort of 187,785 men. They evaluated their risk of developing CVD.
In the prostate cancer group they found that 10,656 men were on antiandrogens (like Casodex) (AA), 26,959 were on gonadotropin-releasing hormone (GnRH) agonists (like Lupron) and 3,747 underwent a surgical orchiectomy.
The risk of developing a CVD was increased in the prostate cancer cohort over the control group in men taking a GnRH agonists. The men with on AA were at decreased risk. They also found that the risk for developing a CVD was highest during the first 6 months of the ADT in men who experienced two or more cardiovascular events before they started the therapy.
These results support the use of ADT in men with prostate cancer despite the increased risk of CVD. However, men with a history, especially within six months of beginning ADT need to proceed more cautiously.
Reference: J Clin Oncol. 2015 Apr 10;33(11):1243-51. O’Farrell S, Garmo H, Holmberg L, Adolfsson J, Stattin P, Van Hemelrijck M, etal.