Prolonged ADT Raises Diabetes, Cardiovascular Risk in Older Men

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For men with prostate cancer older than 70, prolonged androgen deprivation therapy associated with increased risk of diabetes and CVD.
For men with prostate cancer older than 70, prolonged androgen deprivation therapy associated with increased risk of diabetes and CVD.

For men diagnosed with prostate cancer aged older than 70 years, prolonged androgen deprivation therapy is associated with increased risk of diabetes and cardiovascular disease, especially among those with comorbidities, according to a study published in The Journal of Urology.

Alicia K. Morgans, M.D., from Vanderbilt University and Geriatric Research, Education, and Clinical Center in Nashville, Tenn., and colleagues examined the correlation of androgen deprivation therapy exposure (two years or less, more than two years, or none) with incident diabetes and cardiovascular disease in men with nonmetastatic prostate cancer.

The cohort included 3,526 eligible participants, of whom 2,985 were without diabetes and 3,112 were without cardiovascular disease.

The researchers found that in men diagnosed with prostate cancer before age 70 years, androgen deprivation therapy was not associated with an elevated risk of diabetes or cardiovascular disease.

In older men, prolonged androgen deprivation therapy and increasing age at diagnosis correlated with an increased risk of diabetes (at age 76 years: odds ratio, 2.1) and cardiovascular disease (at age 74 years: odds ratio, 1.9).

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Compared to men without comorbidities, those with comorbidities had greater risk of diabetes (odds ratio, 4.3) and cardiovascular disease (odds ratio, 8.1).

"Older men who receive prolonged androgen deprivation therapy should be closely monitored for diabetes and cardiovascular disease," the authors write.

Several authors disclosed financial ties to the pharmaceutical and biotechnology industries.

Reference

  1. Morgans, Alicia K., et al. "Influence of Age on Incidence Diabetes and Cardiovascular Disease in Prostate Cancer Survivors Receiving Androgen Deprivation Therapy." The Journal of Urology. DOI: http://dx.doi.org/10.1016/j.juro.2014.11.006. [epub ahead of print]. November 10, 2014.

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