Cardiovascular events among patients with prostate cancer treated with abiraterone and enzalutamide

Authors

  • Onur Baser Department of Economics, Bogazici University, Bebek, Istanbul, Turkiye; Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA; Graduate School of Public Health, City University of New York, New York, USA https://orcid.org/0000-0001-7447-5672
  • Gabriela Samayoa Columbia Data Analytics, New York, New York, USA
  • Archana Dwivedi Columbia Data Analytics, New York, New York, USA
  • Sara AlSaleh Columbia Data Analytics, Ann Arbor, Michigan, USA
  • Burhan Cigdem Mergen Analytics, Ankara, Turkey
  • Erdi Kizilkaya Mergen Analytics, Ankara, Turkey

DOI:

https://doi.org/10.2340/1651-226X.2024.20337

Keywords:

prostate cancer, abiraterone, enzalutamide, cardiovascular adverse events, androgen deprivation therapy, hormone therapy

Abstract

Background and purpose: There is growing concern about the adverse metabolic and cardiovascular effects of abiraterone acetate (AA) and enzalutamide (ENZ), two standard hormonal therapies for prostate cancer. We analysed the risk of cardiovascular adverse events among patients treated with AA and ENZ.

Patients and methods: We used Kythera Medicare data from January 2019 to June 2023 to identify patients with at least one pharmacy claim for AA or ENZ. The index date was the first prescription claim date. Patients were required to have 1 year of data pre- and post-index date. New users excluded those with prior AA or ENZ claims and pre-existing cardiovascular comorbidities. Demographic and clinical variables, including age, socioeconomic status (SES), comorbidity score, prostate-specific comorbidities, and healthcare costs, were analysed . Propensity score matching was employed for risk adjustment.

Results: Of the 8,929 and 8,624 patients in the AA and ENZ cohorts, respectively, 7,647 were matched after adjusting for age, sociodemographic, and clinical factors. Between the matched cohorts (15.54% vs. 14.83%, p < 0.05), there were no statistically significant differences in any cardiovascular event after adjusting for these factors. The most common cardiovascular event in both cohorts was heart failure (5.20% vs. 4.49%), followed by atrial fibrillation (4.42% vs. 3.60%) and hypotension (2.93% vs. 2.48%).

Interpretation: This study provides real-world evidence of the cardiovascular risk of AA and ENZ that may not appear in clinical trial settings. Adjusting for age, baseline comorbidities, and SES, the likelihood of a cardiovascular event did not differ between treatment groups.

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Published

2024-04-09

How to Cite

Baser, O., Samayoa, G., Dwivedi, A., AlSaleh, S., Cigdem, B., & Kizilkaya, E. (2024). Cardiovascular events among patients with prostate cancer treated with abiraterone and enzalutamide. Acta Oncologica, 63(1), 137–146. https://doi.org/10.2340/1651-226X.2024.20337

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Section

Short report