Julio Hajdenberg, MD, FACP
Is continuous androgen-deprivation therapy (ADT) associated with diabetes mellitus, myocardial infarction, cardiovascular mortality, or fragility fractures in older men with prostate cancer?
Cohort study with linkage of administrative databases; mean follow-up was 6.5 years.
38 158 men ≥ 66 years of age (mean age 75 y) with prostate cancer were identified from the Ontario Cancer Registry. ADT users (n = 19 079) had received medical ADT (luteinizing hormone–releasing hormone agonists, nonsteroidal antiandrogens, and/or steroidal antiandrogens) continuously for ≥ 6 months or had bilateral orchiectomy. Non-ADT users (n = 19 079) had not received ADT after prostate cancer diagnosis and were matched with ADT users on age at diagnosis, prior radical prostatectomy, and on a propensity score based on age at time of study, year of diagnosis, comorbidity, medication use, and socioeconomic factors.
Development of myocardial infarction, sudden cardiac death, and diabetes (≥ 30 d after starting ADT). Secondary outcomes included fragility fractures.
Men who used ADT were at greater risk for diabetes and fragility fractures but not myocardial infarction or sudden cardiac death (Table).
Continuous ADT use was associated with increased risk for diabetes and fragility fractures but not myocardial infarction or sudden cardiac death in older men with prostate cancer.
Associations between androgen-deprivation therapy (ADT) and adverse outcomes in older men with prostate cancer*
*CI defined in Glossary.
†Adjusted for income quintile and rurality.
‡Not statistically significant.
Hajdenberg J. Continuous androgen-deprivation therapy increased risk for diabetes and fragility fractures in older men with prostate cancer. Ann Intern Med. ;151:JC6–14. doi: 10.7326/0003-4819-151-12-200912150-02014
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Published: Ann Intern Med. 2009;151(12):JC6-14.
Cardiology, Coronary Risk Factors, Diabetes, Endocrine and Metabolism, Geriatric Medicine.
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