A serious and well-known side effect of ADT is increased risk of cardiovascular disease. However, a comparison of this risk according to the type of ADT had not been undertaken until now. In this study from the UK researchers examined the risk of cardiovascular disease by ADT type in a cohort of over 20,000 prostate cancer patients. The researchers documented the risk of cardiovascular events associated with 1) GnRH agonists (Zoladex, Lupron), bicalutamide monotherapy (Casodex), and the newer GnRH antagonist degarelix (Firmagon). To do so, they examined health records from the Scottish Cancer Registry and Scottish National Prescribing Information System.
When compared to men who were not on ADT, men on ADT had a 30% increase in cardiovascular events. However, this was only observed in men who were on two types of ADT: 1) the GnRH agonists (e.g., Zoladex, Lupron) and 2) degarelix (Firmagon). An increase in risk was not found with bicalutamide monotherapy. According to the authors, this was the first study to report an increased risk of cardiovascular disease associated with degarelix (Firmagon).
The results reinforce the importance of carefully monitoring cardiovascular health while on ADT. As we have noted before, physical activity and a heart-healthy diet can help reduce one’s risk of adverse cardiovascular side effects when on ADT.
To read the study abstract, see:
Cardwell, C. R., O’Sullivan, J. M., Jain, S., Harbinson, M. T., Cook, M. B., Hicks, B. M., Mc Menamin, U. C. (2019). The risk of cardiovascular disease in prostate cancer patients receiving androgen deprivation therapies. Epidemiology. Oct 21 [Advance online publication].