Testosterone-Blocking Drugs Increase Heart Disease Risk When Used in Combination, Study Finds
Harvard Health Publishing has reported on a new study indicating that the combination of testosterone-blocking drugs, commonly used in the treatment of prostate cancer, can significantly increase the risk of heart disease.
The drugs in question, androgen deprivation therapies (ADT) and androgen-receptor signaling inhibitors (ARSIs), are known to improve survival rates for men with prostate cancer. ADT works by shutting down the body’s production of testosterone, while ARSIs block the hormone from binding to its cell receptor.
Key Points of the Study:
- The study, published in June, involved a systematic review of 24 clinical trials that included a total of 22,166 men aged 63 to 77.
- The trials evaluated the use of ADT alone and in combination with ARSIs for the treatment of various stages of prostate cancer, from nonmetastatic to metastatic forms.
- The primary goal was to compare the cardiac event rates associated with ADT alone versus intensified ADT, which includes the addition of ARSIs.
Findings:
- The combination of ADT and ARSIs approximately doubles the risk of cardiac events, including hypertension, cardiac arrhythmias, blood clots, heart attacks, and strokes.
- The risk of severe grade 3 cardiac events, which may require hospitalization, ranged from 7.8% to 15.6%.
- The use of two ARSIs, abiraterone acetate and enzalutamide, in combination increased the risk of severe cardiac events even further.
Implications:
- The study’s authors recommend that men receiving intensified ADT should be thoroughly counseled about the increased cardiovascular risks and monitored for signs of heart disease before and after treatment begins.
- The findings underscore the importance of balancing the benefits of cancer treatment with the potential side effects on cardiovascular health.
Quote:
Charlie Schmidt, Editor at Harvard Medical School Annual Report on Prostate Diseases, states, Cancer treatment can involve difficult tradeoffs, and that’s also true of the testosterone-blocking drugs used in treating prostate cancer. This study highlights the need for careful monitoring and management of cardiovascular side effects in patients receiving these treatments.
Editorial Note:
This research serves as a crucial reminder for healthcare providers and patients alike that while the combination of ADT and ARSIs can be effective in treating prostate cancer, it is essential to be vigilant about the potential risks to heart health. As always, the decision to use these drugs should be made on a case-by-case basis, taking into account the individual patient’s overall health and risk factors.
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