Abstract

Introduction: Androgen deprivation therapy (ADT), a backbone treatment for advanced prostate cancer (PC) is known to have a variety of metabolic side effects. We conducted an updated meta-analysis to quantify metabolic risks of ADT. Hypothesis: We hypothesized that ADT would increase the risk for metabolic diseases compared to PC patients not on ADT. Methods: We searched PubMed, Web of Science, and Scopus in May of 2022 for studies that investigated the risk of metabolic syndrome (MetS), diabetes, and hypertension from ADT in PC patients using keywords. 4 blinded reviewers screened studies. Only studies that had a comparison group of PC patients not on ADT were included. For included studies, relative risk (RR) was pooled using a random effects model. Results: 1846 records were screened, of which 19 were found suitable for data extraction (Figure 1). 5 studies including 831 patients had MetS as an outcome, with the random effects model showing a pooled RR of 1.49 ([95% Confidence Interval (CI), 1.01-2.21]; I 2 =59%: p=0.04) for patients on ADT. 12 studies including 409,490 patients examined diabetes as an outcome, and the random effects model showed a RR of 1.40 (95% CI, 1.28-1.54), while 4 studies including 7,051 patients examined hypertension as an outcome, and the random effects model showed a RR of 1.30 (95% CI, 1.08-1.55) in ADT patients. Conclusions: ADT was shown to increase the risk of MetS, diabetes, and hypertension in patients with PC undergoing ADT compared to PC patients not on ADT. These results should be understood in the context of collaboration between a patient’s oncologist and primary care provider to optimize care.

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