MP48-19 RISK OF METABOLIC AND CARDIOVASCULAR ADVERSE EVENTS WITH ABIRATERONE OR ENZALUTAMIDE AMONG MEN WITH ADVANCED PROSTATE CANCER

Abstract

You have accessJournal of UrologyCME1 May 2022MP48-19 RISK OF METABOLIC AND CARDIOVASCULAR ADVERSE EVENTS WITH ABIRATERONE OR ENZALUTAMIDE AMONG MEN WITH ADVANCED PROSTATE CANCER Lillian Lai, Mary Oerline, Megan Caram, Phoebe Tsao, Samuel Kaufman, Brent Hollenbeck, and Vahakn Shahinian Lillian LaiLillian Lai More articles by this author , Mary OerlineMary Oerline More articles by this author , Megan CaramMegan Caram More articles by this author , Phoebe TsaoPhoebe Tsao More articles by this author , Samuel KaufmanSamuel Kaufman More articles by this author , Brent HollenbeckBrent Hollenbeck More articles by this author , and Vahakn ShahinianVahakn Shahinian More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002619.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Abiraterone and enzalutamide, used with androgen deprivation, are the most common treatments for men with advanced prostate cancer. Both have anti-androgenic properties and abiraterone is prescribed with prednisone, which may contribute to metabolic or cardiovascular adverse events. To understand the safety of abiraterone and enzalutamide use in real-world settings, we examined the association between the use of these agents and the risk of metabolic or cardiovascular events while on treatment. METHODS: 56,230 men with advanced prostate cancer were identified in a 20% sample of the 2011-2017 national Medicare claims. Abiraterone or enzalutamide use was analyzed as a time-dependent covariate. The primary outcome was the occurrence of a major metabolic or cardiovascular event, defined as an emergency room visit or hospitalization associated with a primary diagnosis of diabetes, hypertension, or cardiovascular disease. The secondary outcome was the occurrence of a minor metabolic or cardiovascular event, defined as an outpatient visit associated with a primary diagnosis of the aforementioned conditions. Men who experienced an event of interest in the 12 months prior to the study start date were excluded. The risks of primary and secondary composite outcomes were assessed using Cox regression. The occurrence of adverse events by specific diagnoses was also examined individually. RESULTS: Per unadjusted incidence rates, men receiving abiraterone had 1 additional emergency room visit/hospitalization due to a cardiovascular event for every 29 men treated (median time on drug: 4.7 months). Compared to men not receiving abiraterone, men receiving the drug were at increased risk of both a major composite adverse event (HR 1.77 95% CI 1.53-2.05 p <0.01) and a minor composite adverse event (HR 1.24 95% CI 1.05-1.47 p=0.01) (Table). Compared to men not receiving enzalutamide, men receiving enzalutamide were at an increased risk of a major composite adverse event (HR 1.22 95% CI 1.01-1.48 p=0.04) but not a minor composite adverse event (HR 1.04 95% CI 0.83-1.30 p=0.75). CONCLUSIONS: Treatment with abiraterone or enzalutamide is associated with increased risk of major metabolic or cardiovascular events in real-world settings. Source of Funding: AHRQ R01HS027507NCI T32 CA180984 Prostate Cancer Foundation © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e828 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lillian Lai More articles by this author Mary Oerline More articles by this author Megan Caram More articles by this author Phoebe Tsao More articles by this author Samuel Kaufman More articles by this author Brent Hollenbeck More articles by this author Vahakn Shahinian More articles by this author Expand All Advertisement PDF DownloadLoading ...