Cardiovascular risk profiles of GnRH agonists and antagonists: real-world analysis from UK general practice
| Autor: | Patrick Davey, Michael G Kirby |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Oncology
Agonist Male medicine.medical_specialty endocrine system medicine.drug_class Urology medicine.medical_treatment Population General Practice 030232 urology & nephrology Lower risk Cardiovascular Risk Assessment Androgen deprivation therapy Cohort Studies Gonadotropin-Releasing Hormone 03 medical and health sciences Prostate cancer chemistry.chemical_compound Degarelix 0302 clinical medicine Internal medicine medicine GnRH antagonist Humans education GnRH agonist Aged Aged 80 and over education.field_of_study business.industry Incidence Prostatic Neoplasms medicine.disease Topic Paper United Kingdom chemistry Cardiovascular Diseases Heart Disease Risk Factors 030220 oncology & carcinogenesis Relative risk Hormone therapy business hormones hormone substitutes and hormone antagonists |
| Zdroj: | World Journal of Urology |
| ISSN: | 1433-8726 0724-4983 |
| Popis: | Purpose Androgen deprivation therapy (ADT) is the mainstay for the management of metastatic prostate cancer. Available pharmaceutical ADTs include gonadotropin-releasing hormone (GnRH) agonists and antagonists. Here, real-world data are presented from the UK general practitioner Optimum Patient Care Research Database. The study investigated the hypothesis that GnRH antagonists have lower cardiac event rates than GnRH agonists. Methods The incidence of cardiac events following initiation of GnRH antagonist or agonist therapy was investigated in a population-based cohort study conducted in UK primary care between 2010 and 2017. Results Analysis of real-world data from the UK primary care setting showed that relative risk of experiencing cardiac events was significantly lower with degarelix, a GnRH antagonist, compared with GnRH agonists (risk ratio: 0.39 [95% confidence interval 0.191, 0.799]; p = 0.01). Patients that received degarelix as first-line treatment switched treatment more frequently (33.7%), often to a GnRH agonist, than those who initiated treatment with a GnRH agonist (6.7–18.6%). Conclusion Screening for known or underlying vascular disease and identifying those at high risk of a cardiac event is important for risk mitigation in patients with prostate cancer receiving hormone therapy. The GnRH antagonist degarelix conferred a significantly lower risk of cardiac events than GnRH agonists. Prior to treatment, patients should be stratified based on level of cardiovascular (CV) risk, and appropriate lifestyle, and pharmacological interventions to mitigate CV risk should be recommended. CV risk factors and patient response to the intervention should be monitored at regular intervals. |
| Databáze: | OpenAIRE |
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