Gonadotropin-releasing hormone antagonist associated with lower cardiovascular risk compared with gonadotropin-releasing hormone agonist in prostate cancer: A nationwide cohort and in vitro study
| Autor: | Yung-Chang Lin, Cheng-Lung Hsu, Po-Jung Su, See-Tong Pang, I-Chang Hsieh, Jong-Hwei S. Pang, John Wen-Cheng Chang, Miao-Sui Lin, Ming-Jer Hsieh, Cheng-Keng Chuang, Chi-Nan Tseng, Shao-Wei Chen, Lai-Chu See, Jia-Rou Liu, Wen-Kuan Huang, Pao-Hsien Chu, Dong-Yi Chen |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Agonist Adult Male medicine.medical_specialty medicine.drug_class THP-1 Cells Urology Taiwan Lower risk Gonadotropin-releasing hormone antagonist Androgen deprivation therapy Cohort Studies Gonadotropin-Releasing Hormone 03 medical and health sciences chemistry.chemical_compound Prostate cancer Young Adult 0302 clinical medicine Gonadotropin-releasing hormone agonist Internal medicine medicine Humans Degarelix Aged Aged 80 and over business.industry Hazard ratio Prostatic Neoplasms Middle Aged medicine.disease 030104 developmental biology Endocrinology Oncology chemistry Matrix Metalloproteinase 9 Cardiovascular Diseases Heart Disease Risk Factors 030220 oncology & carcinogenesis Leuprolide business Oligopeptides Follow-Up Studies |
| Zdroj: | The ProstateREFERENCES. 81(12) |
| ISSN: | 1097-0045 |
| Popis: | Background We aimed to determine whether cardiovascular (CV) risk in patients with prostate cancer (PCa) differs between those who receive gonadotropin-releasing hormone (GnRH) agonist (GnRHa) therapy and those who receive GnRH antagonist therapy. Methods Using the Taiwan National Health Insurance Research Database, we analyzed data by comparing 666 participants receiving GnRH antagonists and 1332 propensity score-matched participants treated with GnRHa in a 1:2 fashion during the period from May 1, 2015, to September 30, 2018. Cox proportional-hazards models were used to estimate the treatment effect on CV outcomes. Furthermore, we conducted an in vitro study to investigate the effect of a GnRHa (leuprolide) or a GnRH antagonist (degarelix) on matrix metalloproteinase-9 (MMP-9) expression and invasion ability in THP-1 differentiated macrophages. Results GnRH antagonist therapy was associated with a lower risk of composite CV events of myocardial infarction, ischemic stroke, or CV death (hazard ratio [HR], 0.48; 95% confidence interval [CI], 0.25-0.90) than GnRHa therapy, with a mean follow-up period of 1.21 years. Significantly lower risks of CV death (HR, 0.21; 95% CI, 0.06-0.70) and all-cause mortality (HR, 0.77; 95% CI, 0.61-0.97) were observed in the GnRH antagonist group. In the in vitro study, leuprolide, but not degarelix, significantly increased the expression of MMP-9 activity and the invasive ability of THP-1 differentiated macrophages through gelatin zymography and the matrix invasion assay, respectively. Conclusion GnRH antagonists were associated with reduced risk CV events compared with the GnRHa among patients with PCa, which may be through effects on macrophages. |
| Databáze: | OpenAIRE |
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