I’ll start with the first one, a very large analysis of the French database, which basically showed cardiovascular risk to be similar in men taking LHRH agonists or GnHR antagonists. It may be meta-analysis from taking phase 3 randomized controlled trials. There’s definitely controversy around much of the literature out there because we know that much of it is going to be retrospective analysis from large health care databases.
antagonist, what is the implications of the 2 different mechanisms? If we look at it, there are quite a few pieces of literature. Based on studies, we’ve known that this is due to suppression of the testosterone DHT, LH, and cortisol, leading to this increase in fat mass and cholesterol, which we know eventually is going to have a significant impact for patients with preexisting cardiovascular disease. This all ties back to that there is this inappropriate metabolic syndrome that is involved with having the ADT therapies. And the ACS Survivorship Care Guidelines simply indicate that men should be evaluated for cardiovascular risk and monitoring blood pressure and other risk factors associated with cardiovascular disease.īhavesh Shah, RPh, BCOP: There’s definitely been a lot of interesting literature around the different risk factors of androgen deprivation therapies that exist.
antagonists, the NCCN guidelines don’t differentiate between agonist and antagonist therapy. While there is good evidence to support that there is likely an increased risk with agonists vs. Professional society guidelines aren’t real clear, however, on the role of GnRH antagonists vs.
As a result, we should be evaluating those risks for cardiovascular disease when making treatment decisions in patients with prostate cancer. There have been a number of studies since that time that show there is an increased risk of coronary vascular morbidity and mortality in patients getting GnRH agonists compared to antagonists. Fox, MD, MHA: As far back as 2010, several societies recognized that there is increased risk associated with treatment with androgen deprivation therapy, specifically and primarily, GnRH agonist therapy. The links above were extracted from the older (Dec 2014) version of official dev site using Archive.John L.
Just for the reference, here are direct links to download latest supported version of Android SDK with Eclipse ADT plugin:
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