Chris Wong1,2, Peggy Chu3,4, Jeremy Teoh1,2, Peter Chiu1,2, C H Yee1,2, Lysander Chau3,4, Marco Chan3,4, Helen Wan1, Steven Leung1, C F Ng5,6,7,8. 1. SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China. 2. Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China. 3. Urology Division, Department of Surgery, Tuen Mun Hospital, Tuen Mun, Hong Kong, China. 4. Urology Division, Department of Surgery, Pok Oi Hospital, Yuen Long, Hong Kong, China. 5. SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China. ngcf@surgery.cuhk.edu.hk. 6. Division of Urology, Department of Surgery, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong, China. ngcf@surgery.cuhk.edu.hk. 7. Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China. ngcf@surgery.cuhk.edu.hk. 8. Division of Urology, Department of Surgery, North District Hospital, Sheung Shui, Hong Kong, China. ngcf@surgery.cuhk.edu.hk.
Abstract
PURPOSE: Androgen deprivation therapy (ADT) use in prostate cancer (PCa) has seen a rising trend. We are looking into the relationship between ADT and development of metabolic diseases in Chinese patients. METHODS: This is a prospective multi-centre cohort yielded from the READT database (Real-life experience of ADT in Asia), in which patients diagnosed of PCa and offered ADT were prospectively recruited since 2016. Chinese patients recruited from Hong Kong were selected and compared to another cohort of newly diagnosed PCa patients in Hong Kong (HK-Cap database), which was collected prospectively and retrieved retrospectively for this study. Patient outcomes are followed through for 2 years. We compared between the groups the new diagnoses of hypertension, diabetes and hyper-lipidaemia, as well as the initiation of related medication for these conditions. Baseline characteristics including pre-treatment comorbidities, medications and tumour characteristics are documented. RESULTS: 151 patients receiving ADT (from READT database) and 447 patients not receiving ADT (from HK-Cap database) were analysed. ADT is related to higher risks of developing any of concerned medical co-morbidities (23.8% vs 13.0*, p = 0.001) and new-onset DM (16.6% vs 4.4%, p < 0.001). Initiation of new medications is also more common in ADT patients. New anti-hypertensives (37.8% vs 12.5%, p < 0.001), oral hypoglycemic agents (12.6% vs 4.9%, p = 0.001), insulin (4.0% vs 0.05%, p = 0.001) and statin (23.7% vs 12.8%, p = 0.023) are more commonly added in ADT cohort. CONCLUSION: Chinese receiving ADT are exposed to increased risks of new-onset hypertension, diabetes and hyper-lipidaemia, and a higher likelihood of stepping up pharmaceutical control for pre-existing comorbidities. This highlights physicians' role to monitor metabolic profiles in at-risk men upon offering ADT.
PURPOSE: Androgen deprivation therapy (ADT) use in prostate cancer (PCa) has seen a rising trend. We are looking into the relationship between ADT and development of metabolic diseases in Chinese patients. METHODS: This is a prospective multi-centre cohort yielded from the READT database (Real-life experience of ADT in Asia), in which patients diagnosed of PCa and offered ADT were prospectively recruited since 2016. Chinese patients recruited from Hong Kong were selected and compared to another cohort of newly diagnosed PCa patients in Hong Kong (HK-Cap database), which was collected prospectively and retrieved retrospectively for this study. Patient outcomes are followed through for 2 years. We compared between the groups the new diagnoses of hypertension, diabetes and hyper-lipidaemia, as well as the initiation of related medication for these conditions. Baseline characteristics including pre-treatment comorbidities, medications and tumour characteristics are documented. RESULTS: 151 patients receiving ADT (from READT database) and 447 patients not receiving ADT (from HK-Cap database) were analysed. ADT is related to higher risks of developing any of concerned medical co-morbidities (23.8% vs 13.0*, p = 0.001) and new-onset DM (16.6% vs 4.4%, p < 0.001). Initiation of new medications is also more common in ADT patients. New anti-hypertensives (37.8% vs 12.5%, p < 0.001), oral hypoglycemic agents (12.6% vs 4.9%, p = 0.001), insulin (4.0% vs 0.05%, p = 0.001) and statin (23.7% vs 12.8%, p = 0.023) are more commonly added in ADT cohort. CONCLUSION: Chinese receiving ADT are exposed to increased risks of new-onset hypertension, diabetes and hyper-lipidaemia, and a higher likelihood of stepping up pharmaceutical control for pre-existing comorbidities. This highlights physicians' role to monitor metabolic profiles in at-risk men upon offering ADT.
Authors: J C Smith; S Bennett; L M Evans; H G Kynaston; M Parmar; M D Mason; J R Cockcroft; M F Scanlon; J S Davies Journal: J Clin Endocrinol Metab Date: 2001-09 Impact factor: 5.958
Authors: Matthew R Smith; Joel S Finkelstein; Francis J McGovern; Anthony L Zietman; Mary Anne Fallon; David A Schoenfeld; Philip W Kantoff Journal: J Clin Endocrinol Metab Date: 2002-02 Impact factor: 5.958
Authors: Axel Heidenreich; Patrick J Bastian; Joaquim Bellmunt; Michel Bolla; Steven Joniau; Theodor van der Kwast; Malcolm Mason; Vsevolod Matveev; Thomas Wiegel; Filiberto Zattoni; Nicolas Mottet Journal: Eur Urol Date: 2013-11-12 Impact factor: 20.096
Authors: Padraig Warde; Malcolm Mason; Keyue Ding; Peter Kirkbride; Michael Brundage; Richard Cowan; Mary Gospodarowicz; Karen Sanders; Edmund Kostashuk; Greg Swanson; Jim Barber; Andrea Hiltz; Mahesh K B Parmar; Jinka Sathya; John Anderson; Charles Hayter; John Hetherington; Matthew R Sydes; Wendy Parulekar Journal: Lancet Date: 2011-11-02 Impact factor: 79.321
Authors: Neal D Shore; Emmanuel S Antonarakis; Michael S Cookson; E David Crawford; Alicia K Morgans; David M Albala; Jason Hafron; Richard G Harris; Daniel Saltzstein; Gordon A Brown; Jonathan Henderson; Benjamin Lowentritt; Jeffrey M Spier; Raoul Concepcion Journal: Prostate Date: 2020-03-04 Impact factor: 4.104