Comparing the risk of cardiovascular disease following GnRH agonist and GnRH antagonist therapy for patient with prostate cancer: a systematic review and meta-analysis

2021 ◽  
Vol 73 (3) ◽  
Author(s):  
Chengquan MA ◽  
Iruni R. ABEYSEKERA ◽  
Wenbin XU ◽  
Ying WANG ◽  
Jia PENG ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Gnrh Agonist ◽  
Gnrh Antagonist ◽  
Meta Analysis ◽  
Antagonist Therapy

scholarly journals Switching from a GnRH agonist to a GnRH antagonist in prostate cancer patients: A systematic review and meta-analysis

2019 ◽  
Vol 14 (2) ◽  
Author(s):  
Kaleem S. Atchia ◽  
Christopher J.D. Wallis ◽  
Neil Fleshner ◽  
Paul Toren
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Gnrh Agonist ◽  
Gnrh Antagonist ◽  
Meta Analysis ◽  
Specific Antigen ◽  
Patient Characteristics ◽  
Agonist Therapy ◽  
Clinical Responses ◽  
Key Terms

Introduction: We sought to address whether there are clinical responses when patients who are failing gonadotropin-releasing hormone (GnRH) agonist therapy are switched to degarelix. Androgen-deprivation therapy remains the backbone of treatment for disseminated prostate cancer and may be achieved with orchiectomy, GnRH agonists, or degarelix, a GnRH antagonist. Methods: To perform a systematic review and meta-analysis, a search of the BIOSIS Previews, Embase, International Pharmaceutical Abstracts, MEDLINE, and Google Scholar databases was performed using key terms. Quantitative meta-analysis was performed to provide a pooled estimate of prostate-specific antigen (PSA) response at three months. Results: Thirteen studies were identified, eight of which were included in the qualitative and quantitative analyses. Patient characteristics were broadly similar between the studies. Out of 155 patients across all included studies, 20 had stable PSA after the switch (12.9%), 14 had between 10‒30% decrease in PSA (9.0%), three had between 30‒50% decrease (1.9%), and 13 had more than 50% decrease (8.4%). Random effects meta-analysis of these data demonstrated a pooled response rate of 27.75 (95% confidence interval 18.9‒36.5%; I2=7.9%). Changes in testosterone levels following the switch could not be quantitatively assessed due to lack of sufficient data. Conclusions: Our results suggest that a switch to GnRH antagonist following progression on a GnRH agonist may result in a stable or decreased PSA at three months in about 30% of patients. This information should be considered among the potential options to discuss with patients with a rising PSA on GnRH agonist therapy.

Dual triggering with GnRH agonist plus hCG versus triggering with hCG alone for IVF/ICSI outcome in GnRH antagonist cycles: a systematic review and meta-analysis

2018 ◽  
Vol 298 (1) ◽  
pp. 17-26 ◽  
Author(s):  
Chi-Huang Chen ◽  
Chii-Ruey Tzeng ◽  
Peng-Hui Wang ◽  
Wei-Min Liu ◽  
Heng-Yu Chang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gnrh Agonist ◽  
Gnrh Antagonist ◽  
Meta Analysis

scholarly journals Is Androgen Deprivation Therapy for Prostate Cancer Associated with Cardiovascular disease ? A Meta-Analysis and systematic review.

2019 ◽  
Author(s):  
Zhen Liang ◽  
Longlong Chen ◽  
Yawei Xu ◽  
Yongjiao Yang ◽  
Rui Hu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Androgen Deprivation Therapy ◽  
Disease Risk ◽  
Meta Analysis ◽  
Androgen Deprivation ◽  
Increased Risk ◽  
Significant Difference ◽  
The Relationship

Abstract Background: Whether androgen deprivation therapy (ADT) is associated with an increased risk of developing cardiovascular related disease is poorly defined. The aim of the present meta‐analysis is to explore the relationship between ADT and the risk of cardiovascular disease (CVD). Method: For this systematic review and meta-analysis, we searched databases until April 2019 for randomized controlled trial (RCT) or observational studies that reported data on ADT administration and cardiovascular disease (CVD) incidence. The relationship was evaluated through estimate relative risk ratio (RR) and 95% confidence intervals (CIs) Result: A statistically significant difference was detected for acute myocardial infarction (AMI) (RR = 1.13; 95% CI, 1.10–1.15; P< 0.05) including a total of 142,186 cases and 174,404 controls. Significant difference between coronary heart disease (CHD) and ADT was also observed, with summary (RR=1.11; 95% confidence interval CI: 1.10-1.13), from 157,339 ADT users and 349,636 non-ADT users of 7 eligible studies. Conclusions: Pooled result demonstrated that ADT could significantly increase the risk of CHD, AMI and sudden cardiac death (SCD). Various ADT modalities have different impact on cardiovascular disease risk in different level. Our meta-analysis also suggests that the application of ADT in prostate cancer patients for over 5 years resulted in a significant increase in cardiovascular morbidity. Moreover, subgroup analyses for different types of ADT indicated that compared with the individual administration of ADT, GnRH plus AA (oral anti-androgens) is more likely significantly lead to AMI.

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