PMID- 34672938
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220319
IS  - 1911-6470 (Print)
IS  - 1920-1214 (Electronic)
IS  - 1911-6470 (Linking)
VI  - 16
IP  - 3
DP  - 2022 Mar
TI  - Time trends of drug-specific actionable adverse events among patients on androgen 
      receptor antagonists: Implications for remote monitoring.
PG  - E146-E149
LID - 10.5489/cuaj.7437 [doi]
AB  - INTRODUCTION: In light of COVID-19, reducing patient exposure via remote 
      monitoring is desirable. Patients prescribed abiraterone/ enzalutamide are 
      scheduled for monthly in-person appointments to screen for adverse events (AEs). 
      We determined time trends of drug-specific actionable AEs among users of 
      abiraterone/enzalutamide to assess the safety of remote monitoring. METHODS: A 
      chart review was conducted on 828 prostate cancer patients prescribed abiraterone 
      and/or enzalutamide. Data were collected to determine time to actionable first 
      AEs, including hypertension, elevated liver enzymes (aspartate transaminase 
      [AST], alanine transaminase [ALT]), hyperbilirubinemia, and hypokalemia. Survival 
      analysis was used to determine time to AEs. RESULTS: In this study, 425 and 403 
      patients received enzalutamide and abiraterone, respectively. In total, 25.6% of 
      those who took enzalutamide experienced an AE, compared to 28.8% of patients on 
      abiraterone. For patients using abiraterone and experiencing an AE, cumulative 
      incidence of AEs at three, six, nine, and 12 months were: 67.2%, 81.9%, 90.5%, 
      and 93.9%, respectively. Among enzalutamide users experiencing an AE, cumulative 
      incidence of AEs at three, six, nine, and 12 months were 51.4%, 70.7%, 82.6%, and 
      88.1%, respectively. The AEs associated with enzalutamide were hypertension and 
      liver dysfunction (77.1% and 22.9%, respectively). In the abiraterone group, 
      associated AEs were liver dysfunction (47.4%), hypertension (47.4%), and 
      hypokalemia (5.2%). CONCLUSIONS: Attaining AEs secondary to 
      abiraterone/enzalutamide decreases over time and tends to occur within the first 
      six months of therapy. Most actionable AEs can be remotely monitored. Given 
      COVID-19, remote monitoring after six months of initiating abiraterone or 
      enzalutamide appears appropriate.
FAU - Fleshner, Lauren
AU  - Fleshner L
AD  - Division of Urology, University Health Network, University of Toronto, Toronto, 
      ON, Canada.
FAU - Berlin, Alejandro
AU  - Berlin A
AD  - Department of Radiation Oncology, University Health Network, University of 
      Toronto, Toronto, ON, Canada.
FAU - Hersey, Karen
AU  - Hersey K
AD  - Division of Urology, University Health Network, University of Toronto, Toronto, 
      ON, Canada.
FAU - Kenk, Miran
AU  - Kenk M
AD  - Division of Urology, University Health Network, University of Toronto, Toronto, 
      ON, Canada.
FAU - Lajkosz, Katherine
AU  - Lajkosz K
AD  - Division of Urology, University Health Network, University of Toronto, Toronto, 
      ON, Canada.
FAU - Nguyen, Susan
AU  - Nguyen S
AD  - Division of Urology, University Health Network, University of Toronto, Toronto, 
      ON, Canada.
FAU - Wise, Jacob
AU  - Wise J
AD  - Division of Urology, University Health Network, University of Toronto, Toronto, 
      ON, Canada.
FAU - O'Halloran, Sophie
AU  - O'Halloran S
AD  - Division of Urology, University Health Network, University of Toronto, Toronto, 
      ON, Canada.
LA  - eng
PT  - Journal Article
PL  - Canada
TA  - Can Urol Assoc J
JT  - Canadian Urological Association journal = Journal de l'Association des urologues 
      du Canada
JID - 101312644
PMC - PMC8923887
COIS- Competing interests: The authors do not report any competing personal or 
      financial interests related to this work.
EDAT- 2021/10/22 06:00
MHDA- 2021/10/22 06:01
PMCR- 2022/03/01
CRDT- 2021/10/21 20:46
PHST- 2021/10/22 06:00 [pubmed]
PHST- 2021/10/22 06:01 [medline]
PHST- 2021/10/21 20:46 [entrez]
PHST- 2022/03/01 00:00 [pmc-release]
AID - cuaj.7437 [pii]
AID - cuaj-4-e146 [pii]
AID - 10.5489/cuaj.7437 [doi]
PST - ppublish
SO  - Can Urol Assoc J. 2022 Mar;16(3):E146-E149. doi: 10.5489/cuaj.7437.