Second-generation antiandrogens may increase cognitive decline, fatigue and falls in patients with prostate cancer

Written By : Aditi |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-06-28T20:00:15+05:30 | Updated On 28 Jun 2023 8:00 PM IST

According to an Original Investigation published in JAMA Oncology, researchers have concluded that prostate cancer patients treated with second-generation antiandrogens (AAs) are at greater risk of cognitive or functional toxic effects, including fatigue and falls, in their systematic review and meta-analysis of 12 randomized clinical trials of 13 524 participants.

Using second-generation antiandrogens (AAs) for treating prostate cancer is increasing. Previous research has mentioned an association between second-generation AAs and adverse cognitive and functional outcomes. There is a lack of evidence and data from prospective trials.

In this study, researchers determined if evidence from randomized clinical trials (RCTs) in prostate cancer supports an association between second-generation AAs and cognitive or functional toxic effects.

For this, researchers collected data from PubMed, EMBASE, and Scopus. They included RCTs of second-generation AAs (abiraterone, apalutamide, darolutamide, or enzalutamide) among prostate cancer patients that evaluated cognitive toxic effects, asthenic toxic effects (e.g., fatigue, weakness), or falls.

The study results are as follows:

There were 12 studies comprising 13 524 participants.
These studies had a low risk of bias.
Those taking second-generation AAs had an increased risk of cognitive toxic effects and fatigue compared to those in the control arms.
Increased age was tied to a greater risk of fatigue with second-generation AAs.
Using second-generation AAs had an increased risk of falls.

Concluding further, based on this systematic review and meta-analysis findings, second-generation AAs carry an increased risk of cognitive and functional toxic effects, including when added to traditional forms of hormone therapy.

Based on the study’s findings, there is a need to prevent, identify, and intervene in cognitive and functional toxic effects in prostate cancer patients receiving second-generation AAs.

BDS, MDS in Periodontics and Implantology

Dr. Aditi Yadav is a BDS, MDS in Periodontics and Implantology. She has a clinical experience of 5 years as a laser dental surgeon. She also has a Diploma in clinical research and pharmacovigilance and is a Certified data scientist. She is currently working as a content developer in e-health services. Dr. Yadav has a keen interest in Medical Journalism and is actively involved in Medical Research writing.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751