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Review of major adverse effects of androgen-deprivation therapy in men with prostate cancer
Cancer, 04/29/09

Taylor LG et al. - In a review of major adverse effects of androgen-deprivation therapy (ADT) in men with prostate cancer, it was concluded that ADT is associated with increased risk of skeletal fracture, incident diabetes, and cardiovascular-related mortality, although the absolute risk of these events was low. Preventive measures against these adverse effects and careful assessment of pt's baseline health status should be considered.

Methods

Literature on skeletal and cardiac side effects associated with ADT was systematically reviewed and quantitatively assessed in men with prostate cancer.
PubMed database was searched for relevant published articles from 1966 to May 2008, and 683 articles were reviewed systematically from an original 20 different Medical Subject Heading search combinations.
Focus of the review was on bone-related and cardiovascular-related outcomes.
When appropriate, results were pooled from articles on specific adverse outcomes, summary risk estimates were calculated, and tests of heterogeneity were performed.

Results

14 articles were identified that met inclusion criteria from the original 683 studies.
Men who underwent ADT for prostate cancer had a significantly increased risk of overall fracture of 23% vs men who had prostate cancer but who did not undergo ADT.
Men who underwent ADT had a 17% increase in cardiovascular-related mortality vs men who did not undergo with ADT.
Significant elevations in the risk of diabetes also were observed from 2 large studies.

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