Prevalence of Cardiovascular Disease and Osteoporosis During Androgen Deprivation Therapy Prescription Discordant to EAU Guidelines: Results From a Multicenter, Cross-sectional Analysis From the CHOsIng Treatment for Prostate canCEr (CHOICE) Study

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• 作者：Giuseppe Morgia¹ ; Giorgio Ivan Russo¹ ; ^{giorgioivan@virgilio.it" class="auth_mail" title="E-mail the corresponding author} ; Andrea Tubaro² ; Roberto Bortolus³ ; Donato Randone⁴ ; Pietro Gabriele⁵ ; Fabio Trippa⁶ ; Filiberto Zattoni⁷ ; Massimo Porena⁸ ; Vincenzo Mirone⁹ ; Sergio Serni¹⁰ ; Alberto Del Nero¹¹ ; Giancarlo Lay¹² ; Umberto Ricardi¹³ ; Francesco Rocco¹⁴ ; Carlo Terrone¹⁵ ; Arcangelo Pagliarulo¹⁶ ; Giuseppe Ludovico¹⁷ ; Giuseppe Vespasiani¹⁸ ; Maurizio Brausi¹⁹ ; Claudio Simeone²⁰ ; Giovanni Novella²¹ ; Giorgio Carmignani²² ; Rosario Leonardi²³ ; Paola Pinnarò ; ⁵ ; Ugo De Paula²⁴ ; Renzo Corvò ; ²⁵ ; Raffaele Tenaglia²⁶ ; Salvatore Siracusano²⁷ ; Giovanna Mantini²⁸ ; Paolo Gontero²⁹ ; Gianfranco Savoca³⁰ ; Vincenzo Ficarra³¹ ; (Members of L. U. N. A. Foundation ; Società ; Italiana d'Urologia)
• 刊名：Urology
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：96
• 期：Complete
• 页码：165-170
• 全文大小：410 K

文摘

To analyze the prevalence of cardiovascular disease (CVD) and osteoporosis in patients treated with androgen deprivation therapy (ADT) for prostate cancer (PCa) but not adherent to European Association of Urology (EAU) guidelines.

Materials and Methods

The CHOosIng Treatment for Prostate CanCEr (CHOICE) study was an Italian multicenter, cross-sectional study conducted from December 2010 to January 2012. A total of 1386 patients treated with ADT for PCa (first prescription or renewal of ADT) were selected. According to EAU guidelines, the cohort was categorized in discordant ADT (Group A) and concordant ADT (Group B). The prevalence of CVD and osteoporosis after ADT was recorded.

Results

The final cohort included 1075 patients. According to EAU guidelines adherence, 285 (26.51%) and 790 (73.49%) were considered discordant and concordant, respectively. The proportion of men with Charlson Comorbidity Index  > 2 at baseline was statistically similar in Group A (81.8%) compared to Group B (80.8%) (P = .96). The number of complications reported at enrollment was as follows: cardiovascular in 351 (32.7%), endocrine in 166 (15.4%), sexual in 498 (46.3%), osteoporosis in 181 (16.8%), and gynecomastia in 274 (25.5%) subjects. At the multivariate logistic regression analysis adjusted for confounding factors, discordant ADT was associated with greater risk of cardiovascular complications (odds ratio: 2.07; P < .01) and osteoporosis (odds ratio: 1.75; P = .04).

Conclusion

About one-third of patients with PCa received inappropriate ADT and showed a greater risk of CVD and osteoporosis. These results could be useful for setting better policy strategies to limit the inappropriateness of ADT prescription.