PMID- 32655041
OWN - NLM
STAT- MEDLINE
DCOM- 20211028
LR  - 20211028
IS  - 1745-7262 (Electronic)
IS  - 1008-682X (Print)
IS  - 1008-682X (Linking)
VI  - 23
IP  - 1
DP  - 2021 Jan-Feb
TI  - Androgen deprivation therapy and side effects: are GnRH antagonists safer?
PG  - 3-10
LID - 10.4103/aja.aja_22_20 [doi]
AB  - Androgen deprivation therapy (ADT) with gonadotropin-releasing hormone (GnRH) 
      agonists and antagonists is the mainstay of advanced prostate cancer treatment. 
      Both drug classes decrease levels of luteinizing hormone and follicle-stimulating 
      hormones (FSH), thereby lowering testosterone to castrate levels. This is 
      associated with adverse events (AEs), including cardiovascular (CV) disorders, 
      bone fractures, metabolic dysfunction, and impaired cognitive function. This 
      literature review discusses these AEs, with a focus on CV and bone-related 
      events. A hypothesis-generating meta-analysis of six clinical trials showed a 
      potentially increased risk for CV disorders with GnRH agonists versus the GnRH 
      antagonist degarelix. While no study has directly compared GnRH agonists versus 
      antagonists with a primary CV outcome, one hypothesis for this observation is 
      that GnRH agonists lead to initial surges in FSH that may negatively impact CV 
      health, whereas antagonists do not. GnRH agonists are associated with metabolic 
      and cognitive AEs and while data are lacking for GnRH antagonists, no differences 
      in risk are predicted. Other common AEs with ADT include injection site 
      reactions, which are much more common with degarelix than with GnRH agonists, 
      which may reflect differing administration and injection techniques. Future 
      studies are needed to further evaluate and compare the safety profiles of GnRH 
      agonists and antagonists, especially in patients with pre-existing CV disease and 
      other co-morbidities. Physicians should carefully evaluate benefits and risks 
      when prescribing ADT and ensure that side effects are well managed.
FAU - Freedland, Stephen J
AU  - Freedland SJ
AD  - Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los 
      Angeles, CA 90048, USA.
AD  - Section of Urology, Durham VA Medical Center, Durham, NC 27705, USA.
FAU - Abrahamsson, Per-Anders
AU  - Abrahamsson PA
AD  - Department of Urology, Skane University Hospital, Lund University, Malmo 20502, 
      Sweden.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - China
TA  - Asian J Androl
JT  - Asian journal of andrology
JID - 100942132
RN  - 0 (Androgen Antagonists)
RN  - 33515-09-2 (Gonadotropin-Releasing Hormone)
SB  - IM
MH  - Androgen Antagonists/adverse effects/*therapeutic use
MH  - Gonadotropin-Releasing Hormone/*agonists/*antagonists & inhibitors
MH  - Humans
MH  - Male
MH  - Prostatic Neoplasms/*drug therapy
PMC - PMC7831824
OTO - NOTNLM
OT  - androgen antagonists
OT  - metabolic syndrome
OT  - prostate cancer
OT  - safety
COIS- None
EDAT- 2020/07/14 06:00
MHDA- 2021/10/29 06:00
PMCR- 2020/07/10
CRDT- 2020/07/14 06:00
PHST- 2020/07/14 06:00 [pubmed]
PHST- 2021/10/29 06:00 [medline]
PHST- 2020/07/14 06:00 [entrez]
PHST- 2020/07/10 00:00 [pmc-release]
AID - 289430 [pii]
AID - AJA-23-3 [pii]
AID - 10.4103/aja.aja_22_20 [doi]
PST - ppublish
SO  - Asian J Androl. 2021 Jan-Feb;23(1):3-10. doi: 10.4103/aja.aja_22_20.