ADT increases risk of diabetes and hypertension in Prostate cancer patients but not metabolic syndrome

The researchers mentioned that ADT increases hypertension risk by 30%.

It is already known that Androgen deprivation therapy (ADT) used for treating advanced prostate cancer (PC) has metabolic side effects.

To quantify the metabolic risk of Androgen deprivation therapy, an updated meta-analysis was conducted by Justin Swaby and colleagues.

The study points are summarised below:

• The researchers collected data and studies from PubMed, Web of Science, and Scopus (May 2022) for studies investigating the risk of MetS, diabetes, and hypertension from ADT using keywords.
• The researchers included studies with a control group of PC patients not on ADT.
• Random effects model and a trim-fill approach were used in the study.
• One thousand eight hundred forty-six records were screened, and 19 were found suitable for data extraction.
• To evaluate MetS (outcome), Five studies, including 891 patients, were assessed.

      The random effects model showed a pooled RR of 1.60 for ADT patients.

• Twelve studies had 336,330 patients and examined diabetes as an outcome.

       The random effects model showed an RR of 1.43.

• ADT increased the risk for diabetes (25%) without any association with MetS (after adjusting for publication bias).
• Four studies with 7,051 patients examined hypertension as an outcome.

       The random effects model showed a RR of 1.30 in ADT patients.

To conclude, ADT increases the risk of hypertension by 30%.

They said, "The results of our study should be understood about collaborating care between a patient's oncologist and primary care provider to optimize care."

Findings support the National Comprehensive Cancer Network guideline recommendations that ADT should not be initiated in patients with localized prostate cancer since it does not improve long-term OS or DFS.

The study's limitation includes Heterogeneity across studies.

Further reading:

Swaby, Justin, et al. "Association of Androgen Deprivation Therapy With Metabolic Disease in Prostate Cancer Patients: An Updated Meta-Analysis." Clinical Genitourinary Cancer, Elsevier BV, Dec. 2022. Crossref, https://doi.org/10.1016/j.clgc.2022.12.006.