A systematic review and meta-analysis of cardiovascular disease risk with degarelix and GnRH agonists in prostate cancer.

IF 2.8 3区 医学 Q2 ONCOLOGY Clinical & Translational Oncology Pub Date : 2024-11-05 DOI:10.1007/s12094-024-03772-2
Francisco Cezar Aquino de Moraes, Vitor Kendi Tsuchiya Sano, Clara Rocha Dantas, Nathália Hoffmeister, Francinny Alves Kelly, Rommel Mario Rodríguez Burbano
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Abstract

Background: Degarelix is a third-generation GnRH receptor antagonist approved for the treatment of prostate cancer, however, the decision to use a GnRH agonist or an antagonist depends on several factors. We aimed to perform a meta-analysis comparing the cardiovascular disease risk between degarelix and gonadotropin-releasing hormone agonists in patients with all stages of prostate cancer.

Methods: Databases were searched for randomized control trials (RCTs) and observational studies that compared the risk of cardiovascular disease between degarelix and GnRH agonists in patients with prostate cancer. We computed for binary endpoints risk ratio (RR) or hazard ratio (HR) with 95% confidence intervals (CI) which were analyzed using a random-effects model.

Results: A total of 15 studies were included with 123,969 patients and follow-up ranging from 3 to 13 months. Degarelix was associated with a significantly lower incidence of major adverse cardiovascular events (RR 0.59; 95% CI 0.41-0.84; p = 0.003; I2 = 84%). Incidence of stroke (RR 0.89; 95% CI 0.56-1.42; p = 0.62; I2 = 0%), all-cause mortality (RR 0.64; 95% CI 0.37-1.13; p = 0.12; I2 = 41%), hypertension (RR 0.71; 95% CI 0.48, 1.04; p = 0.08; I2 = 0%), myocardial infarction (HR 1.04; 95% CI 0·59-1·84; p = 0·86; I2 = 66%), heart failure (HR 0.79; 95% CI 0.38-1.62; p = 0.52; I2 = 79%) and arrhythmia (RR 0.63; 95% CI 0.28-1.41; p = 0.86; I2 = 37%), did not reach a statistically significant difference between groups.

Conclusion: In patients with prostate cancer, degarelix is associated with a significantly lower incidence of major adverse cardiovascular events.

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前列腺癌患者使用地加瑞克和 GnRH 激动剂治疗心血管疾病风险的系统回顾和荟萃分析。
背景:地加瑞克是第三代促性腺激素释放激素受体拮抗剂,已被批准用于治疗前列腺癌,然而,使用促性腺激素释放激素激动剂还是拮抗剂取决于多种因素。我们的目的是进行一项荟萃分析,比较地加瑞克和促性腺激素释放激素激动剂对各期前列腺癌患者的心血管疾病风险:我们在数据库中搜索了比较地加瑞克和促性腺激素释放激素激动剂在前列腺癌患者中心血管疾病风险的随机对照试验(RCT)和观察性研究。我们计算了二元终点的风险比(RR)或危险比(HR)及95%置信区间(CI),并采用随机效应模型进行分析:结果:共纳入15项研究,患者人数为123969人,随访时间为3至13个月。地加瑞克可显著降低主要不良心血管事件的发生率(RR 0.59;95% CI 0.41-0.84;P = 0.003;I2 = 84%)。中风(RR 0.89;95% CI 0.56-1.42;p = 0.62;I2 = 0%)、全因死亡率(RR 0.64;95% CI 0.37-1.13;p = 0.12;I2 = 41%)、高血压(RR 0.71;95% CI 0.48,1.04;p = 0.08;I2 = 0%)、心肌梗死(HR 1.04;95% CI 0-59-1-84;p = 0-86;I2 = 66%)、心力衰竭(HR 0.79;95% CI 0.38-1.62;p = 0.52;I2 = 79%)和心律失常(RR 0.63;95% CI 0.28-1.41;p = 0.86;I2 = 37%),组间差异无统计学意义:结论:在前列腺癌患者中,地加瑞克可显著降低主要不良心血管事件的发生率。
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来源期刊
CiteScore
6.20
自引率
2.90%
发文量
240
审稿时长
1 months
期刊介绍: Clinical and Translational Oncology is an international journal devoted to fostering interaction between experimental and clinical oncology. It covers all aspects of research on cancer, from the more basic discoveries dealing with both cell and molecular biology of tumour cells, to the most advanced clinical assays of conventional and new drugs. In addition, the journal has a strong commitment to facilitating the transfer of knowledge from the basic laboratory to the clinical practice, with the publication of educational series devoted to closing the gap between molecular and clinical oncologists. Molecular biology of tumours, identification of new targets for cancer therapy, and new technologies for research and treatment of cancer are the major themes covered by the educational series. Full research articles on a broad spectrum of subjects, including the molecular and cellular bases of disease, aetiology, pathophysiology, pathology, epidemiology, clinical features, and the diagnosis, prognosis and treatment of cancer, will be considered for publication.
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