Androgen-deprivation Therapy and the Risk of newly Developed Fractures in Patients with Prostate Cancer: A Nationwide Cohort Study in Korea

2021 ◽  
Author(s):  
Do Kyung Kim ◽  
Jong Won Kim ◽  
Hye Sun Lee ◽  
Ju-Young Park ◽  
Hyun Kyu Ahn ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Cox Regression ◽  
Androgen Deprivation ◽  
Proportional Hazard ◽  
Cox Regression Analysis ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Cox Proportional Hazard Regression

Abstract Purpose: We evaluated the risk of osteoporosis and fractures associated with androgen deprivation therapy (ADT) use and duration in men with prostate cancer.Methods: From the nationwide claims database in South Korea, a total of 218,203 men with prostate cancer were identified between 2008 and 2017. To adjust for comorbidities between cohorts, 1:1 propensity score matching was used. Cox proportional hazard regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of events associated with ADT. Results: In the matched cohort, there were differences in the incidence of newly developed osteoporosis (8.79% in the ADT group vs. 7.08% in the non-ADT group, p < 0.0001) and fractures (8.12% in the ADT group vs. 5.04% in the non-ADT group, p < 0.0001). Age-adjusted Cox regression analysis revealed that the ADT group had a significantly higher risk of osteoporosis (HR, 1.381; 95% CI, 1.305–1.461; p < 0.0001) and fractures (HR, 1.815; 95% CI; 1.703–1.935; p < 0.0001) compared to the non-ADT group. Furthermore, the risk of osteoporosis and fractures increased as the duration of ADT increased.Conclusions: The ADT was associated with an increased risk of osteoporosis and fractures in prostate cancer patients.

scholarly journals Androgen-deprivation therapy and the risk of newly developed fractures in patients with prostate cancer: a nationwide cohort study in Korea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Do Kyung Kim ◽  
Hye Sun Lee ◽  
Ju-Young Park ◽  
Jong Won Kim ◽  
Hyun Kyu Ahn ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Cox Regression ◽  
Androgen Deprivation ◽  
Proportional Hazard ◽  
Cox Regression Analysis ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Cox Proportional Hazard Regression

AbstractWe evaluated the risk of osteoporosis and fractures associated with androgen deprivation therapy (ADT) use and duration in men with prostate cancer. From the nationwide claims database in South Korea, a total of 218,203 men with prostate cancer were identified between 2008 and 2017. After applying the inclusion and exclusion criteria, a total of 144,670 patients were included in the analysis. To adjust for comorbidities between cohorts, 1:1 propensity score matching was used. Cox proportional hazard regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of events associated with ADT, after controlling for potential confounding factors. In the matched cohort, there were differences in the incidence of newly developed osteoporosis (8.79% in the ADT group vs. 7.08% in the non-ADT group, p < 0.0001) and fractures (8.12% in the ADT group vs. 5.04% in the non-ADT group, p < 0.0001). Age-adjusted Cox regression analysis revealed that the ADT group had a significantly higher risk of osteoporosis (HR, 1.381; 95% CI, 1.305–1.461; p < 0.0001) and fractures (HR, 1.815; 95% CI, 1.703–1.935; p < 0.0001) compared to the non-ADT group. Furthermore, the risk of osteoporosis and fractures increased as the duration of ADT increased. The ADT was associated with an increased risk of osteoporosis and fractures in prostate cancer patients. Clinicians who administer ADT for patients with prostate cancer should always be mindful of the risk of osteoporosis and fracture, avoid unnecessary ADT, and perform regular bone health check-ups.

The association of androgen deprivation therapy and anxiety among 78,000 patients with localized prostate cancer patients.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 19-19
Author(s):  
Kathryn T Dinh ◽  
Gally Reznor ◽  
Vinayak Muralidhar ◽  
Neil E. Martin ◽  
Peter F. Orio ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Secondary Analysis ◽  
Androgen Deprivation ◽  
Localized Prostate Cancer ◽  
Primary Analysis ◽  
Cox Proportional Hazard ◽  
Increased Risk ◽  
Propensity Matching ◽  
Cox Proportional Hazard Regression

19 Background: Androgen deprivation therapy (ADT) has been associated with cognitive and psychological effects, including depression. ADT may also cause an increased incidence of anxiety; however, most studies have not considered anxiety as an individual outcome. We aimed to determine if receipt of any ADT or longer duration of ADT for prostate cancer is associated with increasing risk of being diagnosed with anxiety. Methods: We identified 78,552 men over 65 with stage I-III prostate cancer using the Surveillance, Epidemiology, and End Results-Medicare linked database from 1992-2006, excluding patients with psychiatric diagnoses within the prior year. Our primary analysis was the association of pharmacologic ADT with the diagnosis of anxiety using Cox-proportional hazard regression with propensity matching. Drug-data for treatment of anxiety was not available. Our secondary analysis was the association of ADT duration with a diagnosis of anxiety. Results: Overall, 43% (33,882) of patients who received ADT and had higher 3-year cumulative incidence of anxiety (4.1% vs. 3.5%) than patients without ADT (p < 0.001). Adjusted cox-analyses with propensity matching demonstrated patients with ADT had a 17% increased risk of anxiety (adjusted hazard ratio [AHR] = 1.17, 95% CI = [1.088-1.263]) compared to patients without ADT (p < 0.0001). The risk of anxiety increased with duration of ADT, from 4.5% with ≤ 6 months, 5.8% with 7-11 months, to 15.7% with ≥ 12 months (p-trend = 0.0123). Conclusions: Pharmacologic ADT is associated with an increased risk of anxiety in this large study of elderly men with localized prostate cancer. This risk increased with longer duration of ADT. Anxiety should be consider among the possible psychiatric effects of ADT and should be discussed along with depression prior to initiating ADT.

scholarly journals Androgen Deprivation Therapy and Cardiovascular Risk in Chinese Patients with Nonmetastatic Carcinoma of Prostate

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Gang Huang ◽  
Chun-Yip Yeung ◽  
Ka Kui Lee ◽  
Jianxiong Liu ◽  
Kwan Lun Ho ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cardiovascular Disease ◽  
Androgen Deprivation Therapy ◽  
Cox Regression ◽  
Subsequent Development ◽  
Composite Endpoint ◽  
Androgen Deprivation ◽  
Chinese Patients ◽  
Cox Regression Analysis ◽  
Primary Composite Endpoint

Background. Androgen deprivation therapy (ADT) in nonmetastatic prostate cancer is unclear. Recent data suggests possible increase in the cardiovascular risks receiving ADT. The aim of the study was to investigate the cardiovascular outcomes in a cohort of Chinese nonmetastatic prostate cancer patients with no previously documented cardiovascular disease.Methods and Results. 745 patients with no previously documented cardiovascular disease and/or diabetes mellitus diagnosed to have nonmetastatic prostate cancer were recruited. Of these, 517 patients received ADT and the remaining 228 did not. After a mean follow-up of 5.3 years, 60 patients developed primary composite endpoint including (1) coronary artery disease, (2) congestive heart failure, and (3) ischemic stroke. Higher proportion of patients on ADT (51 patients, 9.9%) developed composite endpoint compared with those not on ADT (9 patients, 3.9%) with hazard ratio (HR) of 2.06 (95% confidence interval (CI): 1.03–3.24,P=0.04). Furthermore, Cox regression analysis revealed that only the use of ADT (HR: 2.1, 95% CI: 1.03–4.25,P=0.04) and hypertension (HR: 2.0, 95% CI: 1.21–3.33,P<0.01) were independent predictors for primary composite endpoint.Conclusion. ADT in Chinese patients with nonmetastatic prostate cancer with no previously documented cardiovascular disease was associated with subsequent development of cardiovascular events.

scholarly journals Interface of Multiple Sclerosis, Depression, Vascular Disease, and Mortality

Neurology ◽  
2021 ◽  
Vol 97 (13) ◽  
pp. e1322-e1333 ◽  
Author(s):  
Raffaele Palladino ◽  
Jeremy Chataway ◽  
Azeem Majeed ◽  
Ruth Ann Marrie
Keyword(s):  
Multiple Sclerosis ◽  
Vascular Disease ◽  
Population Based ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Depression Status ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Cox Proportional Hazard Regression

Background and ObjectivesTo assess whether the association among depression, vascular disease, and mortality differs in people with multiple sclerosis (MS) compared with age-, sex-, and general practice–matched controls.MethodsWe conducted a population-based retrospective matched cohort study between January 1, 1987, and September 30, 2018, that included people with MS and matched controls without MS from England, stratified by depression status. We used time-varying Cox proportional hazard regression models to test the association among MS, depression, and time to incident vascular disease and mortality. Analyses were also stratified by sex.ResultsWe identified 12,251 people with MS and 72,572 matched controls. At baseline, 21% of people with MS and 9% of controls had depression. Compared with matched controls without depression, people with MS had an increased risk of incident vascular disease regardless of whether they had comorbid depression. The 10-year hazard of all-cause mortality was 1.75-fold greater in controls with depression (95% confidence interval [CI] 1.59–1.91), 3.88-fold greater in people with MS without depression (95% CI 3.66–4.10), and 5.43-fold greater in people with MS and depression (95% CI 4.88–5.96). Overall, the interaction between MS status and depression was synergistic, with 14% of the observed effect attributable to the interaction. Sex-stratified analyses confirmed differences in hazard ratios.DiscussionDepression is associated with increased risks of incident vascular disease and mortality in people with MS, and the effects of depression and MS on all-cause mortality are synergistic. Further studies should evaluate whether effectively treating depression is associated with a reduced risk of vascular disease and mortality.

scholarly journals The Associations of Lipid Profiles With Cardiovascular Diseases and Death in a 10-Year Prospective Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiayi Dong ◽  
Song Yang ◽  
Qian Zhuang ◽  
Junxiang Sun ◽  
Pengfei Wei ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cohort Study ◽  
Cardiovascular Diseases ◽  
Cox Regression ◽  
Density Lipoprotein ◽  
Proportional Hazard ◽  
Cox Regression Analysis ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression ◽  
Preventative Interventions

Background: Dyslipidemia is one of the modifiable risk factors for cardiovascular diseases (CVD). Identifying subjects with lipid abnormality facilitates preventative interventions.Objectives: To evaluate the effects of lipid indices on the risks of ischemic stroke (IS), coronary heart disease (CHD), CVD, all-cause death, and CVD death.Methods: The cohort study of 4,128 subjects started in May 2009 and followed up to July 2020. Restricted cubic spline (RCS) regression analysis was used to explore the dose-response relationship between lipid indices with outcomes. Cox proportional hazard regression analysis was used to estimate the association with a hazard ratio (HR) and 95% CI.Results: RCS analysis showed that there were significant linear associations of TG with IS, non-high-density lipoprotein cholesterol (HDL-C), apolipoprotein B (ApoB), and total cholesterol (TC)/HDL-C ratio with all-cause death, non-HDL-C and RC with CVD death, and significant non-linear associations of ApoB with IS and CVD, TC, LDL-C, ApoAI, and TC/HDL-C ratio with CHD, and TC with all-cause death (all P &lt;0.1). Cox regression analysis revealed that subjects with TC &lt;155 mg/dl (vs. 155–184 mg/dl), &gt; 185 mg/dl (vs. 155–184 mg/dl), and ApoB &lt;0.7 g/l (vs. ≥0.7 g/l) had higher risks of CHD (P &lt; 0.05), the adjusted HRs (95% CIs) were 1.933 (1.248–2.993), 1.561 (1.077–2.261), and 1.502 (1.01–2.234), respectively. Subjects with ApoAI &gt; 2.1 g/l (vs. 1.6–2.1 g/l) and TG &lt;80 mg/dl (vs. 80–177 mg/dl) had higher risks of CVD and all-cause death (P &lt; 0.05), the adjusted HRs (95% CIs) were 1.476 (1.031–2.115) and 1.234 (1.002–1.519), respectively.Conclusions: Lower or higher levels of TC, higher level of ApoAI, and lower level of ApoB were associated with increased risks of CVD, and lower level of TG was associated with increased all-cause death. Maintaining optimal lipid levels would help to prevent CVD and reduce mortality.

scholarly journals AZGP1 Protein Expression in Hormone-Naïve Advanced Prostate Cancer Treated with Primary Androgen Deprivation Therapy

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 520
Author(s):  
Mads Dochedahl Winther ◽  
Gitte Kristensen ◽  
Hein Vincent Stroomberg ◽  
Kasper Drimer Berg ◽  
Birgitte Grønkær Toft ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Prediction Models ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Androgen Deprivation ◽  
Cox Regression Analysis ◽  
Primary Androgen Deprivation Therapy ◽  
Specific Mortality ◽  
Primary Androgen Deprivation

Biomarkers for predicting the risk of castration-resistant prostate cancer (CRPC) in men treated with primary androgen deprivation therapy (ADT) are lacking. We investigated whether Zinc-alpha 2 glycoprotein (AZGP1) expression in the diagnostic biopsies of men with hormone-naïve prostate cancer (PCa) undergoing primary ADT was predictive of the development of CRPC and PCa-specific mortality. The study included 191 patients who commenced ADT from 2000 to 2011. The AZGP1 expression was evaluated using immunohistochemistry and scored as high or low expression. The risks of CRPC and PCa-specific mortality were analyzed using stratified cumulative incidences and a cause-specific COX regression analysis for competing risk assessment. The median follow-up time was 9.8 (IQR: 6.1–12.7) years. In total, 94 and 97 patients presented with low and high AZGP1 expression, respectively. A low AZGP1 expression was found to be associated with a shorter time to CRPC when compared to patients with a high AZGP1 expression (HR: 1.5; 95% CI: 1.0–2.1; p = 0.03). However, the multivariable analysis demonstrated no added benefit by adding the AZGP1 expression to prediction models for CRPC. No differences for PCa-specific mortality between the AZGP1 groups were observed. In conclusion, a low AZGP1 expression was associated with a shorter time to CRPC for PCa patients treated with first-line ADT but did not add any predictive information besides well-established clinicopathological variables.

598: Increased Risk of Newly Diagnosed Comorbidities in Prostate Cancer Patients Treated with Androgen Deprivation Therapy

2007 ◽  
Vol 177 (4S) ◽  
pp. 200-200 ◽  
Author(s):  
Andrea Gallina ◽  
Pierre I. Karakiewicz ◽  
Jochen Walz ◽  
Claudio Jeldres ◽  
Quoc-Dien Trinh ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Newly Diagnosed ◽  
Increased Risk

scholarly journals NRG1 Genetic Variant Influences the Efficacy of Androgen-Deprivation Therapy in Men with Prostate Cancer

Biomedicines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 528
Author(s):  
Shu-Pin Huang ◽  
Yei-Tsung Chen ◽  
Lih-Chyang Chen ◽  
Cheng-Hsueh Lee ◽  
Chao-Yuan Huang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Tyrosine Kinases ◽  
Multiple Testing ◽  
Cox Regression ◽  
Progression Free Survival ◽  
Androgen Deprivation ◽  
Nucleotide Polymorphisms ◽  
Multiple Testing Correction ◽  
Cancer Specific Survival

Neuregulins (NRGs) activate receptor tyrosine kinases of the ErbB family, and play essential roles in the proliferation, survival, and differentiation of normal and malignant tissue cells. We hypothesized that genetic variants of NRG signalling pathway genes may influence treatment outcomes in prostate cancer. To test this hypothesis, we performed a comprehensive analysis to evaluate the associations of 459 single-nucleotide polymorphisms in 19 NRG pathway genes with cancer-specific survival (CSS), overall survival (OS), and progression-free survival (PFS) in 630 patients with prostate cancer receiving androgen-deprivation therapy (ADT). After multivariate Cox regression and multiple testing correction, we found that NRG1 rs144160282 C > T is significantly associated with worsening CSS, OS, and PFS during ADT. Further analysis showed that low expression of NRG1 is closely related to prostate cancer, as indicated by a high Gleason score, an advanced stage, and a shorter PFS rate. Meta-analysis of 16 gene expression datasets of 1,081 prostate cancer samples and 294 adjacent normal samples indicate lower NRG1 expression in the former compared with the latter (p < 0.001). These results suggest that NRG1 rs144160282 might be a prognostic predictor of the efficacy of ADT. Further studies are required to confirm the significance of NRG1 as a biomarker and therapeutic target for prostate cancer.

Association of Dementia-Related Psychosis With Long-term Care Use and Death

Neurology ◽  
2021 ◽  
Vol 96 (12) ◽  
pp. e1620-e1631
Author(s):  
James B. Wetmore ◽  
Yi Peng ◽  
Heng Yan ◽  
Suying Li ◽  
Muna Irfan ◽  
...  
Keyword(s):  
Long Term Care ◽  
Fold Increase ◽  
Proportional Hazard ◽  
Comorbid Conditions ◽  
Term Care ◽  
Risk Of Death ◽  
Cox Proportional Hazard ◽  
Increased Risk ◽  
Cox Proportional Hazard Regression

ObjectiveTo determine the association of dementia-related psychosis (DRP) with death and use of long-term care (LTC); we hypothesized that DRP would be associated with increased risk of death and use of LTC in patients with dementia.MethodsA retrospective cohort study was performed. Medicare claims from 2008 to 2016 were used to define cohorts of patients with dementia and DRP. Outcomes were LTC, defined as nursing home stays of >100 consecutive days, and death. Patients with DRP were directly matched to patients with dementia without psychosis by age, sex, race, number of comorbid conditions, and dementia index year. Association of DRP with outcomes was evaluated using a Cox proportional hazard regression model.ResultsWe identified 256,408 patients with dementia. Within 2 years after the dementia index date, 13.9% of patients developed DRP and 31.9% had died. Corresponding estimates at 5 years were 25.5% and 64.0%. Mean age differed little between those who developed DRP (83.8 ± 7.9 years) and those who did not (83.1 ± 8.7 years). Patients with DRP were slightly more likely to be female (71.0% vs 68.3%) and white (85.7% vs 82.0%). Within 2 years of developing DRP, 16.1% entered LTC and 52.0% died; corresponding percentages for patients without DRP were 8.4% and 30.0%, respectively. In the matched cohort, DRP was associated with greater risk of LTC (hazard ratio [HR] 2.36, 2.29–2.44) and death (HR 2.06, 2.02–2.10).ConclusionsDRP was associated with a more than doubling in the risk of death and a nearly 2.5-fold increase in risk of the need for LTC.

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