Contrary to earlier findings, androgen-deprivation therapy for prostate cancer carries no apparent increased risk for cardiovascular mortality, according to a JAMA meta-analysis. Editorialists, however, express caution.
Researchers examined outcomes from eight randomized trials testing androgen deprivation against control therapy in some 4000 men with unfavorable-risk nonmetastatic prostate cancers.
Androgen deprivation was not associated with increased cardiovascular mortality during roughly 10 years’ follow-up. In fact, both prostate cancer–specific mortality and all-cause mortality were lower with androgen deprivation.
The editorialists point out that the meta-analysis focuses on mortality and does not take into account the possible effects of deprivation on “development or acceleration of cardiovascular disease.” They point to a Swedish registry study from 2010 that found elevated cardiovascular risks in all prostate cancers — and the risks increased with androgen deprivation. They recommend that men with cardiac disease undergoing androgen deprivation “should follow the appropriate secondary preventive measures.”
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