TY - JOUR
T1 - Association of Androgen Deprivation Therapy with Metabolic Disease in Prostate Cancer Patients
T2 - An Updated Meta-Analysis
AU - Swaby, Justin
AU - Aggarwal, Ankita
AU - Batra, Akshee
AU - Jain, Anubhav
AU - Seth, Lakshya
AU - Stabellini, Nickolas
AU - Bittencourt, Marcio Sommer
AU - Leong, Darryl
AU - Klaassen, Zachary
AU - Barata, Pedro
AU - Sayegh, Nicolas
AU - Agarwal, Neeraj
AU - Terris, Martha
AU - Guha, Avirup
N1 - Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2023/6
Y1 - 2023/6
N2 - Background: Androgen deprivation therapy (ADT), a backbone treatment for advanced prostate cancer (PC), is known to have a variety of metabolic side effects. We conducted an updated meta-analysis to quantify the metabolic risks of ADT. Materials and Methods: We searched PubMed, Web of Science, and Scopus in May of 2022 for studies investigating the risk of metabolic syndrome (MetS), diabetes, and hypertension from ADT in PC patients using keywords. Only full-length studies with a control group of PC patients not on ADT were included. All results compatible with each outcome domain in each included study were sought. For included studies, relative risk (RR) was pooled using a random effects model and a trim-fill approach was used to adjust for publication bias. Results: 1,846 records were screened, of which 19 were found suitable for data extraction. Five studies, including 891 patients, were evaluated for MetS as an outcome, with the random effects model showing a pooled RR of 1.60 ([95% Confidence Interval (CI), 1.06–2.42]; P=0.03) for patients on ADT while twelve studies, including 336,330 patients, examined diabetes as an outcome, and the random effects model showed a RR of 1.43 ([95% CI, 1.28–1.59]; P< 0.01). After adjustment for publication bias, ADT was associated with a 25% increased risk for diabetes but was not associated with MetS. 4 studies, including 7,051 patients, examined hypertension as an outcome, and the random effects model showed a RR of 1.30 ([95% CI, 1.08–1.55]; P=0.18) in ADT patients. Conclusion: In patients with PC, ADT was not associated with MetS and the association with diabetes was not as strong as previously reported. Our novel meta-analysis of hypertension showed that ADT increased the risk of hypertension by 30%. These results should be understood in the context of collaborating care between a patient's oncologist and primary care provider to optimize care.
AB - Background: Androgen deprivation therapy (ADT), a backbone treatment for advanced prostate cancer (PC), is known to have a variety of metabolic side effects. We conducted an updated meta-analysis to quantify the metabolic risks of ADT. Materials and Methods: We searched PubMed, Web of Science, and Scopus in May of 2022 for studies investigating the risk of metabolic syndrome (MetS), diabetes, and hypertension from ADT in PC patients using keywords. Only full-length studies with a control group of PC patients not on ADT were included. All results compatible with each outcome domain in each included study were sought. For included studies, relative risk (RR) was pooled using a random effects model and a trim-fill approach was used to adjust for publication bias. Results: 1,846 records were screened, of which 19 were found suitable for data extraction. Five studies, including 891 patients, were evaluated for MetS as an outcome, with the random effects model showing a pooled RR of 1.60 ([95% Confidence Interval (CI), 1.06–2.42]; P=0.03) for patients on ADT while twelve studies, including 336,330 patients, examined diabetes as an outcome, and the random effects model showed a RR of 1.43 ([95% CI, 1.28–1.59]; P< 0.01). After adjustment for publication bias, ADT was associated with a 25% increased risk for diabetes but was not associated with MetS. 4 studies, including 7,051 patients, examined hypertension as an outcome, and the random effects model showed a RR of 1.30 ([95% CI, 1.08–1.55]; P=0.18) in ADT patients. Conclusion: In patients with PC, ADT was not associated with MetS and the association with diabetes was not as strong as previously reported. Our novel meta-analysis of hypertension showed that ADT increased the risk of hypertension by 30%. These results should be understood in the context of collaborating care between a patient's oncologist and primary care provider to optimize care.
KW - Cardio-oncology
KW - Cardiovascular risk
KW - Diabetes
KW - Hypertension
KW - Metabolic syndrome
UR - http://www.scopus.com/inward/record.url?scp=85149843161&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85149843161&partnerID=8YFLogxK
U2 - 10.1016/j.clgc.2022.12.006
DO - 10.1016/j.clgc.2022.12.006
M3 - Article
C2 - 36621463
AN - SCOPUS:85149843161
SN - 1558-7673
VL - 21
SP - e182-e189
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
IS - 3
ER -