Mp60-06 Evaluation of Cardiovascular Events Among Men With Prostate Cancer Treated With Androgen Receptor Signaling Inhibitors: A Systematic Review, Meta-Analysis, and Network Meta-Analysis

You have accessJournal of UrologyProstate Cancer: Advanced (Including Drug Therapy) III (MP60)1 May 2024MP60-06 EVALUATION OF CARDIOVASCULAR EVENTS AMONG MEN WITH PROSTATE CANCER TREATED WITH ANDROGEN RECEPTOR SIGNALING INHIBITORS: A SYSTEMATIC REVIEW, META-ANALYSIS, AND NETWORK META-ANALYSIS Akihiro Matsukawa, Takafumi Yanagisawa, Pawel Rajwa, Mehdi Kardoust Parizi, Ekaterina Laukhtina, Jakob Klemm, Sever Chiujdea, Tamas Fazekas, Keiichiro Mori, Shoji Kimura, Jun Miki, Takahiro Kimura, and Shahrokh F. Shariat Akihiro MatsukawaAkihiro Matsukawa , Takafumi YanagisawaTakafumi Yanagisawa , Pawel RajwaPawel Rajwa , Mehdi Kardoust PariziMehdi Kardoust Parizi , Ekaterina LaukhtinaEkaterina Laukhtina , Jakob KlemmJakob Klemm , Sever ChiujdeaSever Chiujdea , Tamas FazekasTamas Fazekas , Keiichiro MoriKeiichiro Mori , Shoji KimuraShoji Kimura , Jun MikiJun Miki , Takahiro KimuraTakahiro Kimura , and Shahrokh F. ShariatShahrokh F. Shariat View All Author Informationhttps://doi.org/10.1097/01.JU.0001008804.84010.ec.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Although the recent introduction of androgen-receptor signaling inhibitors (ARSI) has dramatically changed the treatment strategies for advanced prostate cancer (PCa), the association between ARSIs and cardiovascular events is unclear. We aimed to analyze the risk of cardiovascular events in advanced PCa patients with ARSIs and compare them with each other. METHODS: In August 2023, we queried PubMed, Scopus, and Web of Science databases to identify randomized controlled studies (RCTs) that analyze advanced PCa patients treated with abiraterone, enzalutamide, apalutamide, and darolutamide. The primary interests of the measure were the incidence of cardiac disorder, heart failure, coronary artery disorder (CAD), atrial fibrillation, and hypertension. Network meta-analyses (NMAs) were conducted to compare the differential outcomes in each ARSI compared to androgen deprivation therapy alone as standard of care (SOC). RESULTS: Overall, 22 RCTs were included in the analyses. ARSIs were associated with an increased risk of cardiac disorder (RR: 1.41, 95%CI: 1.13-1.76) and hypertension (RR: 1.84, 95%CI: 1.47-2.32). Based on NMAs, abiraterone (RR 1.77; 95%CI 1.39-2.26) and enzalutamide (RR 2.20; 95%CI 1.66-2.91) increase the risk of hypertension compared to SOC. In addition, abiraterone demonstrated a significant increase in the risk of cardiac disorder (RR 1.53; 95%CI 1.15-2.04). Darolutamide did not show a significant risk increase compared to SOC. No standards in reporting cardiovascular events on each RCT limit the analyses. CONCLUSIONS: We found that ARSIs elevate cardiovascular risk compared to SOC in advanced PCa. Different ARSIs present distinct profiles, highlighting the importance of cautious patient selection and monitoring for subsequent cardiovascular disease. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1001 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Akihiro Matsukawa More articles by this author Takafumi Yanagisawa More articles by this author Pawel Rajwa More articles by this author Mehdi Kardoust Parizi More articles by this author Ekaterina Laukhtina More articles by this author Jakob Klemm More articles by this author Sever Chiujdea More articles by this author Tamas Fazekas More articles by this author Keiichiro Mori More articles by this author Shoji Kimura More articles by this author Jun Miki More articles by this author Takahiro Kimura More articles by this author Shahrokh F. Shariat More articles by this author Expand All Advertisement PDF downloadLoading ...