Persistence and adherence to androgen deprivation therapy in men with prostate cancer: an administrative database study.

Q1 Medicine Minerva Urologica E Nefrologica Pub Date : 2020-10-01 Epub Date: 2019-12-12 DOI:10.23736/S0393-2249.19.03595-1

Luca Cindolo, Piergustavo De Francesco, Nicola Petragnani, Felice Simiele, Michele Marchioni, Andrea Logreco, Caterina Di Fabio, Michele De Tursi, Nicola Tinari, Luigi Schips

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引用次数: 9

Abstract

Background: The aim of this study was to assess adherence to and persistence with androgen deprivation therapy (ADT) in a large cohort of prostate cancer (PCa) patients selected from an administrative database, with special attention to elderly patients.

Methods: Patients treated with LHRH analogues, LHRH antagonists, the novel androgen antagonist enzalutamide, and the CYP17 inhibitor abiraterone were included spanning the years 2011-2017. Descriptive statistics were used to analyze persistence and adherence in older patients stratified by age (46-55, 56-65, 66-75, 76-85, and >85 years). The effect of persistence duration on overall survival in super-elderly patients was analyzed by the Kaplan-Meier method, together with the influence of multiple prescriptions on overall survival.

Results: A total of 1160 male patients were treated with ADT. Of these, 1075 were given LHRH analogues, 80 LHRH antagonists, 14 novel androgen antagonists, and 109 the CYP17 inhibitor. Median adherence values were 0.93, 0.97, 0.95, and 0.99 respectively. The highest persistence was recorded for LHRH analogues/antagonists (24 months), followed enzalutamide and abiraterone (8 months). A total of 107 patients (9.2%) were classified as super-elderly (age range 85-97 years). Median persistence and OS in this group were 13 months and 29 months, respectively. The adherence was 0.92. Overall survival was significantly associated with additional prescriptions for other conditions-indications (P=0.0047) but not with differences in adherence rates (P=0.98).

Conclusions: Our data showed high adherence and persistence rates in men on ADT. The overall survival in the super-elderly is not influenced by persistence and/or adherence but rather by coprescriptions.

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前列腺癌患者雄激素剥夺治疗的持久性和依从性:一项行政数据库研究。

背景:本研究的目的是评估从管理数据库中选择的前列腺癌(PCa)患者中雄激素剥夺治疗(ADT)的依从性和持久性，特别关注老年患者。方法:纳入2011-2017年间接受LHRH类似物、LHRH拮抗剂、新型雄激素拮抗剂恩杂鲁胺和CYP17抑制剂阿比特龙治疗的患者。使用描述性统计分析按年龄分层(46-55岁、56-65岁、66-75岁、76-85岁和>85岁)的老年患者的持久性和依从性。采用Kaplan-Meier法分析超高龄患者持续时间对总生存期的影响，以及多种处方对总生存期的影响。结果:共有1160例男性患者接受了ADT治疗。其中，1075人给予LHRH类似物，80人给予LHRH拮抗剂，14人给予新型雄激素拮抗剂，109人给予CYP17抑制剂。中位依从值分别为0.93、0.97、0.95和0.99。LHRH类似物/拮抗剂的持续时间最长(24个月)，其次是恩杂鲁胺和阿比特龙(8个月)。107例(9.2%)患者被归类为超老年(年龄范围85-97岁)。该组中位持续时间和总生存期分别为13个月和29个月。依从性为0.92。总生存率与其他条件适应症的额外处方显著相关(P=0.0047)，但与依从率的差异无关(P=0.98)。结论:我们的数据显示，男性ADT的依从性和持久性很高。超高龄患者的总生存率不受持久性和/或依从性的影响，而是受共同处方的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Minerva Urologica E Nefrologica UROLOGY & NEPHROLOGY-

CiteScore

5.50

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： The journal Minerva Urologica e Nefrologica publishes scientific papers on nephrology and urology. Manuscripts may be submitted in the form of Minerva opinion editorials, editorial comments, original articles, video illustrated articles, review articles and letters to the Editor.