Individual classes of prostate cancer therapies impact risk of Alzheimer’s disease: A claims‐based retrospective study

Abstract

AbstractBackgroundProstate cancer is the most prevalent non‐skin cancer in men and the second leading cause of cancer related deaths among men worldwide. There are growing concerns regarding a potential association between androgen targeting therapeutic exposure and Alzheimer’s disease (AD) where the existent literature is limited and highly controversial. The object of this study was to determine whether androgen targeting therapy (ATT) exposure is associated with risk of Alzheimer’s (AD) in men with prostate cancer in the Symphony claims data set.MethodsPatients receiving ATT for prostate cancer treatment were identified and survival analysis, stratified by age and by individual therapeutics, was used to determine the association between EMT exposure and diagnosis of AD. A propensity score approach was used to minimize measured and unmeasured selection bias. Individual classes of ATT were examined to determine risk impact profiles for each therapeutic target of hormone ablation in prostate cancer treatment.ResultsIn this cohort study of propensity score matched men, all ATT class exposure taken together was associated with no impact in diagnosis of neurodegenerative disease (RR, 1.01; 95% CI, 0.96‐1.07; P = 0.56). The class of androgen synthesis inhibitors were associated with a decreased risk of AD (RR, 0.61; 95% CI, 0.46‐0.80; P < 0.001) whereas the class of androgen receptor blockers were associated with an increased risk of AD (RR, 1.29; 95% CI, 1.13‐1.34; P < 0.001). All other classes of ATT were associated with increased AD risk.ConclusionAmong male patients with prostate cancer, exposure to the androgen synthesis inhibitor class of androgen targeting therapy was associated with a decrease in diagnosis of AD and Dementia. All other types of ATT were associated with an increased risk of AD diagnosis. These data help to explain the current controversies in the literature where groups reporting impact of ATT as a composite of each individual drug suggest contradicting results on AD risk. Funding: This study was supported by grants from the Women’s Alzheimer’s Movement, National Institute on Aging grants P01AG026572 Perimenopause in Brain Aging and Alzheimer's Disease and T32AG061897 Translational Research in AD and related Dementias (TRADD) to RDB.