Pharmacologic androgen deprivation and cardiovascular disease risk factors: A systematic review - Abstract

BACKGROUND: Pharmacologic androgen deprivation therapy (ADT) is widely used to treat prostate cancer.

Observational studies suggest ADT is associated with cardiovascular disease and its risk factors; however, such studies may be subject to bias. Our objective was to evaluate the effect of ADT on cardiovascular disease risk factors from randomised controlled trials (RCTs).

MATERIALS AND METHODS: We conducted a systematic review using MEDLINE and MEDLINE In-Process (1950-June 2013), EMBASE (1974-June 2013), and Web of Science (1900-June 2013) for all RCTs in men with prostate cancer that compared pharmacologic ADT (i.e., use of gonadotropin-releasing hormone agonist or antagonist) with a group that did not receive ADT and reported data on cardiovascular disease risk factors including blood pressure, cholesterol, triglycerides, fibrinogen, biomarkers of insulin sensitivity, adiposity, and C-reactive protein. We also searched for on-going or unpublished trials. This study was registered at the PROSPERO International Prospective Register of Systematic Reviews (CRD42013005097).

RESULTS: Out of the 3272 unique publications identified in our systematic review, we did not identify a single RCT that reported data on any cardiovascular disease risk factor. We were unable to locate unreported data from corresponding authors.

CONCLUSIONS: There is a lack of published, reliable evidence describing the effects of ADT on cardiovascular disease risk factors. RCTs have likely collected data on these risk factors as part of routine study monitoring; however, these data have not been published. In order to understand the effect of ADT on cardiovascular morbidity, these data must be made available to the scientific community.

Written by:
Romo ML, McCrillis AM, Brite J, Reales D, Dowd JB, Schooling CM.   Are you the author?
CUNY School of Public Health, Hunter College, Epidemiology and Biostatistics, 2180 Third Avenue, New York, 10035.

Reference: Eur J Clin Invest. 2015 Mar 7. Epub ahead of print.
doi: 10.1111/eci.12431

PubMed Abstract
PMID: 25753698 Prostate Cancer Section