Kardiovaskuläre Komplikationen unter Androgenentzugstherapie: Vorteil für Gonadotropin-Releasing-Hormon-Antagonisten? Ein Update

Translated title of the contribution: Cardiovascular side effects in patients undergoing androgen deprivation therapy: superiority of gonadotropin-releasing hormone antagonists? An update

Gunhild von Amsberg*, Holger Thiele, Axel Merseburger

*Corresponding author for this work

Abstract

Background: Androgen deprivation therapy (ADT) plays a crucial role in treatment of advanced prostate cancer (PCa). The additional application of new drugs results in prolonged overall survival, both in the hormone sensitive and castration resistant state. Consequently, the long-term use of ADT moves potential side effects into the focus of interest. In this context special consideration must be given to cardiovascular events. Objectives: Review of current evidence on potential differences regarding the cardiovascular risk profile of gonadotropin-releasing hormone (GnRH) agonists compared to GnRH antagonists. Methods: Narrative review based on an expert consensus supported by a literature search in PubMed (MEDLINE) and the abstract databases of ASCO and ESMO was conducted for publications published between January 2015 and January 2021. Significant meta-analyses, randomized controlled trials (RCTs) and real-world data (RWD) revealing relevant results for clinical practice were taken into account. Selection of studies was performed based on the clinical relevance for everyday practice. Results: The search yielded three relevant meta-analyses, two prospective RCTs as well as three RWD publications that are of importance for clinical practice. Overall, a decreased incidence of cardiovascular events was reported for GnRH antagonists compared to GnRH agonists. Only one RWD publication described comparable rates of complications for both drug classes. Conclusion: GnRH antagonists have a lower risk of treatment related cardiovascular events compared to GnRH agonists. Risks should be minimized by taking known cardiovascular risk factors into account before initiating therapy.

Translated title of the contributionCardiovascular side effects in patients undergoing androgen deprivation therapy: superiority of gonadotropin-releasing hormone antagonists? An update
Original languageGerman
JournalUrologe
Volume60
Issue number11
Pages (from-to)1450-1457
Number of pages8
ISSN0340-2592
DOIs
Publication statusPublished - 11.2021

Research Areas and Centers

  • Academic Focus: Center for Brain, Behavior and Metabolism (CBBM)
  • Centers: Cardiological Center Luebeck (UHZL)

DFG Research Classification Scheme

  • 205-23 Reproductive Medicine, Urology
  • 205-17 Endocrinology, Diabetology, Metabolism
  • 205-12 Cardiology, Angiology

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