Abstract
Background
Androgen deprivation therapy (ADT), a backbone treatment for advanced prostate cancer
(PC), is known to have a variety of metabolic side effects. We conducted an updated
meta-analysis to quantify the metabolic risks of ADT.
Materials and Methods
We searched PubMed, Web of Science, and Scopus in May of 2022 for studies investigating
the risk of metabolic syndrome (MetS), diabetes, and hypertension from ADT in PC patients
using keywords. Only full-length studies with a control group of PC patients not on
ADT were included. All results compatible with each outcome domain in each included
study were sought. For included studies, relative risk (RR) was pooled using a random
effects model and a trim-fill approach was used to adjust for publication bias.
Results
1,846 records were screened, of which 19 were found suitable for data extraction.
Five studies, including 891 patients, were evaluated for MetS as an outcome, with
the random effects model showing a pooled RR of 1.60 ([95% Confidence Interval (CI),
1.06–2.42]; P=0.03) for patients on ADT while twelve studies, including 336,330 patients, examined
diabetes as an outcome, and the random effects model showed a RR of 1.43 ([95% CI,
1.28–1.59]; P< 0.01). After adjustment for publication bias, ADT was associated with a 25% increased
risk for diabetes but was not associated with MetS. 4 studies, including 7,051 patients,
examined hypertension as an outcome, and the random effects model showed a RR of 1.30
([95% CI, 1.08–1.55]; P=0.18) in ADT patients.
Conclusion
In patients with PC, ADT was not associated with MetS and the association with diabetes
was not as strong as previously reported. Our novel meta-analysis of hypertension
showed that ADT increased the risk of hypertension by 30%. These results should be
understood in the context of collaborating care between a patient's oncologist and
primary care provider to optimize care.
Keywords
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Article info
Publication history
Published online: December 25, 2022
Accepted:
December 21,
2022
Received in revised form:
December 15,
2022
Received:
September 19,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
