Prevalence of glucocorticoid use in prostate cancer patients.

Abstract

336 Background: The prevalence of glucocorticoid (GC) use increases with age consistent with age-acquired diseases such as chronic obstructive pulmonary and inflammatory conditions for which GCs are indicated. GCs are commonly used alone or in combination with other therapies for prostate cancer (PC), but studies of GC treatment patterns in treated and untreated PC patients (pts) have not been widely reported. This study aimed to describe the prevalence of GC use in PC. Methods: Patients with ≥ 2 PC diagnoses or ≥1 claim for a PC therapy and ≥ 12 months continuous eligibility between 1/2005 and 7/2014 were identified in Truven Health MarketScan databases. The index date for the treated cohort (i.e., pts receiving LHRH agonist, adrenal blocker, anti-androgen, chemotherapy, oral mCRPC therapy, surgery or radiation) was defined as the date of the most recent PC treatment. The index date for the untreated cohort (i.e., with PC diagnosis but without PC treatment) was defined as the most recent PC diagnosis date. GC use was summarized post-index, for treated and untreated PC pts using descriptive statistics. Baseline demographics and comorbidities were also reported. Results: A total of 321,113 eligible PC pts were identified. Of these, 223,953 (70%) were untreated and 97,160 (30%) pts were treated with a PC therapy. Untreated pts had a mean age of 68 years and a mean Quan-Charlson comorbidity index (CCI) of 1.7 and treated pts had a mean age of 71 years and a mean CCI of 1.8. Approximately 30% of untreated pts and 40% of treated pts received GCs during the observation period. Among treated pts, 70% of pts receiving chemotherapy and 88% of pts receiving oral mCRPC therapies (abiraterone and enzalutamide) had evidence of GC use. Median daily GC dose was 24 mg in untreated and 20 mg in treated PC pts. Median daily GC dose was 14mg in chemotherapy-treated pts and 10 mg in pts treated with oral mCRPC therapies. Conclusions: GC use is common in pts with PC, including in those not receiving PC therapies. Median daily GC dosages tended to be lower in pts treated with PC therapies than in those without PC therapies. GC use in PC pts may be related to non-PC comorbidities which should be made known to PC physicians.