Detail
Article
Online article
FT
Medvik - BMC
  • Something wrong with this record ?

Cardiovascular events among men with prostate cancer treated with androgen receptor signaling inhibitors: a systematic review, meta-analysis, and network meta-analysis

A. Matsukawa, T. Yanagisawa, MK. Parizi, E. Laukhtina, J. Klemm, T. Fazekas, K. Mori, S. Kimura, A. Briganti, G. Ploussard, PI. Karakiewicz, J. Miki, T. Kimura, P. Rajwa, SF. Shariat

. 2025 ; 28 (2) : 298-308. [pub] 20240905

Language English Country England, Great Britain

Document type Journal Article, Network Meta-Analysis, Systematic Review

Persistent link   https://www.medvik.cz/link/bmc25015600

BACKGROUND: Androgen-receptor pathway inhibitors (ARPIs) have dramatically changed the management of advanced/metastatic prostate cancer (PCa). However, their cardiovascular toxicity remains to be clarified. OBJECTIVE: To analyze and compare the risks of cardiovascular events secondary to treatment of PCa patients with different ARPIs. METHODS: In August 2023, we queried PubMed, Scopus, and Web of Science databases to identify randomized controlled studies (RCTs) that analyze PCa patients treated with abiraterone, apalutamide, darolutamide, and enzalutamide. The primary outcomes of interest were the incidence of cardiac disorder, heart failure, ischemic heart disease (IHD), atrial fibrillation (AF), and hypertension. Network meta-analyses (NMAs) were conducted to compare the differential outcomes of each ARPI plus androgen deprivation therapy (ADT) compared to standard of care (SOC). RESULTS: Overall, 26 RCTs were included. ARPIs were associated with an increased risk of cardiac disorders (RR: 1.74, 95% CI: 1.13-2.68, p = 0.01), heart failure (RR: 2.49, 95% CI: 1.05-5.91, p = 0.04), AF (RR: 2.15, 95% CI: 1.14-4.07, p = 0.02), and hypertension (RR: 2.06, 95% CI: 1.67-2.54, p < 0.01) at grade ≥3. Based on NMAs, abiraterone increased the risk of grade ≥3 cardiac disorder (RR:2.40, 95% CI: 1.42-4.06) and hypertension (RR:2.19, 95% CI: 1.77-2.70). Enzalutamide was associated with the increase of grade ≥3 AF(RR: 3.17, 95% CI: 1.05-9.58) and hypertension (RR:2.30, 95% CI: 1.82-2.92). CONCLUSIONS: The addition of ARPIs to ADT increases the risk of cardiac disorders, including IHD and AF, as well as hypertension. Each ARPI exhibits a distinct cardiovascular event profile. Selecting patients carefully and vigilant monitoring for cardiovascular issues is imperative for those undergoing ARPI + ADT treatment.

References provided by Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc25015600
003      
CZ-PrNML
005      
20250731091120.0
007      
ta
008      
250708s2025 enk f 000 0|eng||
009      
AR
024    7_
$a 10.1038/s41391-024-00886-0 $2 doi
035    __
$a (PubMed)39237679
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a enk
100    1_
$a Matsukawa, Akihiro $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria $u Department of Urology, The Jikei University School of Medicine, Tokyo, Japan $1 https://orcid.org/000000023324762X
245    10
$a Cardiovascular events among men with prostate cancer treated with androgen receptor signaling inhibitors: a systematic review, meta-analysis, and network meta-analysis / $c A. Matsukawa, T. Yanagisawa, MK. Parizi, E. Laukhtina, J. Klemm, T. Fazekas, K. Mori, S. Kimura, A. Briganti, G. Ploussard, PI. Karakiewicz, J. Miki, T. Kimura, P. Rajwa, SF. Shariat
520    9_
$a BACKGROUND: Androgen-receptor pathway inhibitors (ARPIs) have dramatically changed the management of advanced/metastatic prostate cancer (PCa). However, their cardiovascular toxicity remains to be clarified. OBJECTIVE: To analyze and compare the risks of cardiovascular events secondary to treatment of PCa patients with different ARPIs. METHODS: In August 2023, we queried PubMed, Scopus, and Web of Science databases to identify randomized controlled studies (RCTs) that analyze PCa patients treated with abiraterone, apalutamide, darolutamide, and enzalutamide. The primary outcomes of interest were the incidence of cardiac disorder, heart failure, ischemic heart disease (IHD), atrial fibrillation (AF), and hypertension. Network meta-analyses (NMAs) were conducted to compare the differential outcomes of each ARPI plus androgen deprivation therapy (ADT) compared to standard of care (SOC). RESULTS: Overall, 26 RCTs were included. ARPIs were associated with an increased risk of cardiac disorders (RR: 1.74, 95% CI: 1.13-2.68, p = 0.01), heart failure (RR: 2.49, 95% CI: 1.05-5.91, p = 0.04), AF (RR: 2.15, 95% CI: 1.14-4.07, p = 0.02), and hypertension (RR: 2.06, 95% CI: 1.67-2.54, p < 0.01) at grade ≥3. Based on NMAs, abiraterone increased the risk of grade ≥3 cardiac disorder (RR:2.40, 95% CI: 1.42-4.06) and hypertension (RR:2.19, 95% CI: 1.77-2.70). Enzalutamide was associated with the increase of grade ≥3 AF(RR: 3.17, 95% CI: 1.05-9.58) and hypertension (RR:2.30, 95% CI: 1.82-2.92). CONCLUSIONS: The addition of ARPIs to ADT increases the risk of cardiac disorders, including IHD and AF, as well as hypertension. Each ARPI exhibits a distinct cardiovascular event profile. Selecting patients carefully and vigilant monitoring for cardiovascular issues is imperative for those undergoing ARPI + ADT treatment.
650    _2
$a lidé $7 D006801
650    _2
$a mužské pohlaví $7 D008297
650    12
$a antagonisté androgenních receptorů $x škodlivé účinky $x terapeutické užití $7 D059002
650    _2
$a benzamidy $x škodlivé účinky $7 D001549
650    12
$a kardiovaskulární nemoci $x chemicky indukované $x epidemiologie $7 D002318
650    _2
$a nitrily $x škodlivé účinky $7 D009570
650    12
$a nádory prostaty $x farmakoterapie $x patologie $7 D011471
650    _2
$a randomizované kontrolované studie jako téma $7 D016032
650    _2
$a androsteny $7 D000736
650    _2
$a fenylthiohydantoin $7 D010669
655    _2
$a časopisecké články $7 D016428
655    _2
$a síťová metaanalýza $7 D000099094
655    _2
$a systematický přehled $7 D000078182
700    1_
$a Yanagisawa, Takafumi $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria $u Department of Urology, The Jikei University School of Medicine, Tokyo, Japan $1 https://orcid.org/0000000274100712
700    1_
$a Parizi, Mehdi Kardoust $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria $u Department of Urology, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
700    1_
$a Laukhtina, Ekaterina $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria $1 https://orcid.org/0000000289530272
700    1_
$a Klemm, Jakob $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria $u Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
700    1_
$a Fazekas, Tamás $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria $u Department of Urology, Semmelweis University, Budapest, Hungary
700    1_
$a Mori, Keiichiro $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria $u Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
700    1_
$a Kimura, Shoji $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria $u Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
700    1_
$a Briganti, Alberto $u Unit of Urology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy $u Vita-Salute San Raffaele University, Milan, Italy
700    1_
$a Ploussard, Guillaume $u Department of Urology, La Croix du Sud Hospital, Quint Fonsegrives, France
700    1_
$a Karakiewicz, Pierre I $u Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
700    1_
$a Miki, Jun $u Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
700    1_
$a Kimura, Takahiro $u Department of Urology, The Jikei University School of Medicine, Tokyo, Japan $1 https://orcid.org/0000000256731553
700    1_
$a Rajwa, Pawel $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria $u Department of Urology, Medical University of Silesia, Zabrze, Poland $1 https://orcid.org/0000000340736584
700    1_
$a Shariat, Shahrokh F $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. shahrokh.shariat@meduniwien.ac.at $u Department of Urology, Semmelweis University, Budapest, Hungary. shahrokh.shariat@meduniwien.ac.at $u Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA. shahrokh.shariat@meduniwien.ac.at $u Department of Urology, Weill Cornell Medical College, New York, NY, USA. shahrokh.shariat@meduniwien.ac.at $u Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czechia. shahrokh.shariat@meduniwien.ac.at $u Division of Urology, Department of Special Surgery, The University of Jordan, Amman, Jordan. shahrokh.shariat@meduniwien.ac.at $u Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria. shahrokh.shariat@meduniwien.ac.at $u Research Center for Evidence Medicine, Urology Department Tabriz University of Medical Sciences, Tabriz, Iran. shahrokh.shariat@meduniwien.ac.at $1 https://orcid.org/0000000266276179
773    0_
$w MED00008064 $t Prostate cancer and prostatic diseases $x 1476-5608 $g Roč. 28, č. 2 (2025), s. 298-308
856    41
$u https://pubmed.ncbi.nlm.nih.gov/39237679 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y - $z 0
990    __
$a 20250708 $b ABA008
991    __
$a 20250731091114 $b ABA008
999    __
$a ok $b bmc $g 2366451 $s 1252725
BAS    __
$a 3
BAS    __
$a PreBMC-MEDLINE
BMC    __
$a 2025 $b 28 $c 2 $d 298-308 $e 20240905 $i 1476-5608 $m Prostate cancer and prostatic diseases $n Prostate Cancer Prostatic Dis $x MED00008064
LZP    __
$a Pubmed-20250708

Find record

Citation metrics

Archiving options