Androgen deprivation therapy ups cardiovascular, metabolic risk in Asians

Long-term androgen deprivation therapy (ADT) may exacerbate the risk of cardiovascular and metabolic disorders in Asian patients, a recent study has found.

Thirty-six patients with advanced prostate cancer and had been on ADT for 2 years participated in the study. Metabolic and vascular parameters were assessed every 6 months. The study outcomes were assessed using the Framingham Risk Score (overall cardiovascular risk) and the National Cholesterol Education Program/Adult Treatment Panel guidelines (metabolic risk). A parallel group of 24 prostate cancer not on ADT was also included.

At baseline, most of the participants already had cardiovascular and metabolic problems, the most common of which were hypertension, hyperlipidaemia, and diabetes. Framingham scores at baseline were comparable between arms (p=0.720).

Ten patients in the ADT arm and one non-ADT control died before the end of the study. Major reasons were cancer progression, right cerebellar haemorrhage, and sepsis. Excluding two other ADT patients who dropped out, the final sample included 24 patients in the ADT group and 23 in the control arm.

In this final analytic group, researchers saw that the Framingham score jumped from 41.74±20.94 percent at baseline to 47.24±22.86 percent at 2 years. On the other hand, control patients saw a slight drop, from 39.79±19.86 percent to 37.67±19.93 percent over the same time interval. The temporal change in pulse wave velocity mirrored this trend, too, with a larger increase seen in the ADT arm.

In addition, patients who had been on ADT for 2 years were almost five times as likely to develop metabolic syndrome than controls, though the interaction failed to achieve statistical significance (p=0.068).