MP73-05 CARDIOVASCULAR EVENT RISK AS A FUNCTION OF BASELINE RISK FACTORS IN PROSTATE CANCER PATIENTS TREATED WITH DEGARELIX OR LUTEINISING HORMONE-RELEASING HORMONE AGONISTS

You have accessJournal of UrologyProstate Cancer: Advanced I1 Apr 2015MP73-05 CARDIOVASCULAR EVENT RISK AS A FUNCTION OF BASELINE RISK FACTORS IN PROSTATE CANCER PATIENTS TREATED WITH DEGARELIX OR LUTEINISING HORMONE-RELEASING HORMONE AGONISTS Igle de Jong, Asa Tivesten, Alexandre de la Taille, Francesco Montorsi, Anders Malmberg, and Bo-Eric Persson Igle de JongIgle de Jong More articles by this author , Asa TivestenAsa Tivesten More articles by this author , Alexandre de la TailleAlexandre de la Taille More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Anders MalmbergAnders Malmberg More articles by this author , and Bo-Eric PerssonBo-Eric Persson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2681AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The risk of a cardiovascular (CV) event or death in men on androgen deprivation therapy (ADT) for prostate cancer (PCa) is significantly lower in patients receiving the luteinising hormone-releasing hormone (LHRH) antagonist degarelix vs LHRH agonists. Baseline CV disease (CVD), low testosterone and older age were factors influencing risk of CV event or death with ADT. An analysis of pooled data has been performed to investigate whether the hazard ratio (HR) for a CV event between treatments varies with baseline risk factors. METHODS Data were pooled from prospective, comparative randomised trials of degarelix (n=1491) vs. LHRH agonists (n=837); 467 and 1861 patients received 3 months and >7 months of treatment, respectively. CV events or deaths due to any cause were re-analysed. The HR between degarelix and LHRH agonist was adjusted for common baseline disease factors using the Cox proportional hazard model. Exploratory analyses investigating treatment interaction terms are reported. RESULTS Exploratory multivariable Cox regression analyses involving multiple potential risk factors revealed six baseline factors to be dominant in the interaction with treatments. Alcohol (p=0.002), baseline BMI (p=0.043) and CVD history (p=0.046) are well known risk factors for CV events. Testosterone (p=0.045), age (p=0.063) and blood pressure (p=0.088) also showed an interaction effect with treatment. The HR for a CV event with a LHRH antagonist versus an agonist is lower in patients with normal BP. The HR for a CV event decreases as age increases (figure 1a) and as baseline testosterone increases (figure 1b). There was no apparent correlation between age and testosterone in this analysis (p=0.19, t-test), therefore the results are not confounded. CONCLUSIONS This analysis indicates the earlier reported CV benefit of a LHRH antagonist over LHRH agonists is greater in men with PCa of higher age and those with normal BP. The data also indicate the benefit of LHRH antagonist treatment is particularly apparent in men with higher testosterone at baseline. A potential explanation for this difference is the agonist-induced testosterone surge. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e930-e931 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Igle de Jong More articles by this author Asa Tivesten More articles by this author Alexandre de la Taille More articles by this author Francesco Montorsi More articles by this author Anders Malmberg More articles by this author Bo-Eric Persson More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...