PMID- 37464102
OWN - NLM
STAT- Publisher
LR  - 20230718
IS  - 1476-5608 (Electronic)
IS  - 1365-7852 (Linking)
DP  - 2023 Jul 18
TI  - Association between concomitant proton pump inhibitor use and survival of 
      patients with metastatic prostate cancer receiving abiraterone acetate: a 
      post-hoc analysis of pooled data from three randomized controlled trials.
LID - 10.1038/s41391-023-00695-x [doi]
AB  - BACKGROUND: Evidence suggests proton pump inhibitor (PPI) use may attenuate the 
      effect of abiraterone acetate plus prednisone (AAP) in metastatic prostate cancer 
      via the modification of gut microbiota. This study aimed to examine whether 
      concomitant PPI use is associated with survival in patients with metastatic 
      prostate cancer treated with androgen deprivation therapy (ADT) and AAP. METHODS: 
      Post-hoc analysis was conducted in patients with metastatic castration-sensitive 
      prostate cancer (mCSPC) and metastatic castration-resistant prostate cancer 
      (mCRPC) treated in the LATITUDE, COU-AA-301, and COU-AA-302 trials (ADT vs. ADT 
      plus AAP). PPI users and non-users were compared for restricted mean overall 
      survival time (RMOST) and restricted mean progression-free survival time (RMPFST) 
      based on inverse probability of treatment weight (IPTW)-adjusted Kaplan-Meier 
      curves. IPTW-adjusted Cox regression models were used to assess heterogeneity of 
      treatment effect. RESULTS: In patients treated with AAP, PPI use was associated 
      with inferior RMOST [difference (95% confidence interval): -4.2 (-7.0 to -1.4)] 
      and RMPFST [-3.5 (-6.6 to -0.4)] compared with non-users. However, RMOST and 
      RMPFST were similar between PPI users and non-users in patients treated with ADT 
      alone [RMOST, -2.6 (-5.8 to 0.6); RMPFST, -1.7 (-4.8 to 1.4)]. Interaction term 
      analyses did not show evidence of heterogeneity in treatment effect between AAP 
      and ADT, despite the prominent treatment effect shown in mCSPC vs. mCRPC. 
      CONCLUSIONS: PPI use may be associated with inferior survival in patients with 
      metastatic prostate cancer who receive ADT plus AAP. Discontinuing unnecessary 
      PPI use might improve those outcomes.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer Nature Limited.
FAU - Fukuokaya, Wataru
AU  - Fukuokaya W
AUID- ORCID: 0000-0003-1044-912X
AD  - Department of Urology, The Jikei University School of Medicine; 3-25-8, 
      Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan. wfukuokaya@gmail.com.
FAU - Mori, Keiichiro
AU  - Mori K
AD  - Department of Urology, The Jikei University School of Medicine; 3-25-8, 
      Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
FAU - Yanagisawa, Takafumi
AU  - Yanagisawa T
AUID- ORCID: 0000-0002-7410-0712
AD  - Department of Urology, The Jikei University School of Medicine; 3-25-8, 
      Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
FAU - Akazawa, Kohei
AU  - Akazawa K
AD  - Department of Medical Informatics, Niigata University Medical and Dental 
      Hospital; 1-754 Asahimachi-dori, Chuo-ku, Niigata, Japan.
FAU - Shimomura, Tatsuya
AU  - Shimomura T
AD  - Department of Urology, The Jikei University School of Medicine; 3-25-8, 
      Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
FAU - Kimura, Takahiro
AU  - Kimura T
AUID- ORCID: 0000-0002-5673-1553
AD  - Department of Urology, The Jikei University School of Medicine; 3-25-8, 
      Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
LA  - eng
PT  - Journal Article
DEP - 20230718
PL  - England
TA  - Prostate Cancer Prostatic Dis
JT  - Prostate cancer and prostatic diseases
JID - 9815755
SB  - IM
EDAT- 2023/07/19 01:06
MHDA- 2023/07/19 01:06
CRDT- 2023/07/18 23:29
PHST- 2023/04/19 00:00 [received]
PHST- 2023/07/05 00:00 [accepted]
PHST- 2023/06/09 00:00 [revised]
PHST- 2023/07/19 01:06 [medline]
PHST- 2023/07/19 01:06 [pubmed]
PHST- 2023/07/18 23:29 [entrez]
AID - 10.1038/s41391-023-00695-x [pii]
AID - 10.1038/s41391-023-00695-x [doi]
PST - aheadofprint
SO  - Prostate Cancer Prostatic Dis. 2023 Jul 18. doi: 10.1038/s41391-023-00695-x.