San Francisco, CA USA (UroToday.com) Ruessel and colleagues presented abstract 232 describing cardiovascular events among men with prostate cancer using German claims data. In addition to evaluating the relationship between androgen deprivation therapy (ADT) and cardiovascular events overall, they specifically sought to determine whether cardiovascular risk differed between men treated with GnRH
antagonists and agonists. Using a German research database from the Health Risk Institute, the authors performed a retrospective analysis comparing men treated with GnRH agonists or antagonists with men who did not receive ADT during 2009-2013. The endpoint of interest was a composite endpoint including myocardial infarction or ischemic stroke, in addition to the development of another cardiovascular event, including myocardial infarction, sequelae of cerebrovascular disease, ischemic stroke, intracerebral hemorrhage, pulmonary embolism, phlebitis/thrombophlebitis, transient cerebral ischemic attack, and occlusion/stenosis of cerebral arteries.
The authors included 4,436 men who received GnRH agonists, 133 who received GnRH antagonists, and 37,367 who did not receive ADT during this time period. Men treated with ADT had greater comorbidity burden, were older, and had higher risk of baseline cardiovascular disease than men not treated with ADT. Of these, 6.27%, 3.76%, and 4.62% experienced a myocardial infarction or ischemic stroke in the GnRH agonist, GnRH antagonist, and no ADT groups, respectively. Additionally, 11.27%, 7.52%, and 8.38% experienced cardiovascular events in the GnRH agonist, GnRH antagonist, and no ADT groups, respectively. The authors report that raw rates of cardiovascular events were higher among men treated with ADT than among untreated men. P-values from the comparison of these groups were not reported, but the authors report that men treated with GnRH agonists experienced more frequent cardiovascular events than men treated with GnRH antagonists. The authors conclude that treatment with GnRH antagonists is associated with a lower rate of cardiovascular events than treatment with GnRH agonists. Final data comparing these rates between groups in multivariable models in addition to the reported raw event rates will be helpful to confirm these findings. Ferring Pharmaceuticals participated in this work.
Presented By:
Dr. Christoph Ruessel, MD
Reported By:
Alicia K. Morgans, MD, at the 2016 Genitourinary Cancers Symposium - January 7 - 9, 2016 – San Francisco, CA
Assistant Professor of Medicine Medical Oncologist
Vanderbilt - Ingram Cancer Center