Androgen deprivation therapy and the risk of parkinsonism in men with prostate cancer
Purpose Case reports and anecdotal experiences suggest that some men develop parkinsonism after initiating androgen deprivation therapy (ADT) for the treatment of prostate cancer, possibly due to neurophysiological effects of changes in testosterone and/or estrogen. We hypothesized that ADT would in...
Gespeichert in:
| Veröffentlicht in: | World journal of urology 2017-09, Vol.35 (9), p.1417-1423 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1423 |
|---|---|
| container_issue | 9 |
| container_start_page | 1417 |
| container_title | World journal of urology |
| container_volume | 35 |
| creator | Young, James W. S. Sutradhar, Rinku Rangrej, Jagadish Marras, Connie Fleshner, Neil Alibhai, Shabbir M. H. |
| description | Purpose
Case reports and anecdotal experiences suggest that some men develop parkinsonism after initiating androgen deprivation therapy (ADT) for the treatment of prostate cancer, possibly due to neurophysiological effects of changes in testosterone and/or estrogen. We hypothesized that ADT would increase the risk of parkinsonism.
Methods
Using linked administrative databases in Ontario, Canada, men age 40 or older with prostate cancer on continuous ADT for at least 6 months or who underwent bilateral orchiectomy (
n
= 38,931) were matched 1:1 with men with prostate cancer who had never received ADT. Treated and untreated groups were range-matched on age at index date and year of diagnosis, and propensity-matched on comorbidities, medications, cardiovascular risk factors, and socio-economic variables. A competing risk analysis was conducted where the primary outcome was time to a new diagnosis of parkinsonism.
Results
The cohort was followed for a mean of 5.76 years. Based on the results from the multivariable cause-specific hazard regression model, the adjusted relative rate of experiencing parkinsonism among ADT users compared to non-users was 0.74 (95% confidence interval (CI) 0.67–0.83,
p
|
| doi_str_mv | 10.1007/s00345-017-2010-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1869069498</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1935192892</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-bbd472c4e68e98ef50811cfc37645bbfa8072de116dbf89b840a9853611015203</originalsourceid><addsrcrecordid>eNp1kF1LwzAUhoMobk5_gDcS8Mab6jlp2iaXY_gFgjfuOqRtunVb05l0yvbrTdkUEbxK4Dzv-XgIuUS4RYDszgPEPIkAs4gBQrQ7IkPkcRyJjKXHZAgZ4xGXIh6QM-8XEMAUklMyYIIBlyiGZDq2pWtnxtLSrF39obu6tbSbG6fXW6pt2f-pq_2SthVda7esrW9t7RtaW9qE3Gfdzenatb7TnaGFtoVx5-Sk0itvLg7viEwf7t8mT9HL6-PzZPwSFXHGuijPS56xgptUGClMlYBALKpQTHmS55UW4YLSIKZlXgmZCw5aiiROEQETBvGI3Oz7hvnvG-M71dS-MKuVtqbdeIUilZDKXsGIXP9BF-3G2bCdQhknKJmQLFC4p4pwkHemUkFKo91WIajeudo7V0Gl6p2rXchcHTpv8saUP4lvyQFge8CHkp0Z92v0v12_AJPrjCA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1935192892</pqid></control><display><type>article</type><title>Androgen deprivation therapy and the risk of parkinsonism in men with prostate cancer</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Young, James W. S. ; Sutradhar, Rinku ; Rangrej, Jagadish ; Marras, Connie ; Fleshner, Neil ; Alibhai, Shabbir M. H.</creator><creatorcontrib>Young, James W. S. ; Sutradhar, Rinku ; Rangrej, Jagadish ; Marras, Connie ; Fleshner, Neil ; Alibhai, Shabbir M. H.</creatorcontrib><description>Purpose
Case reports and anecdotal experiences suggest that some men develop parkinsonism after initiating androgen deprivation therapy (ADT) for the treatment of prostate cancer, possibly due to neurophysiological effects of changes in testosterone and/or estrogen. We hypothesized that ADT would increase the risk of parkinsonism.
Methods
Using linked administrative databases in Ontario, Canada, men age 40 or older with prostate cancer on continuous ADT for at least 6 months or who underwent bilateral orchiectomy (
n
= 38,931) were matched 1:1 with men with prostate cancer who had never received ADT. Treated and untreated groups were range-matched on age at index date and year of diagnosis, and propensity-matched on comorbidities, medications, cardiovascular risk factors, and socio-economic variables. A competing risk analysis was conducted where the primary outcome was time to a new diagnosis of parkinsonism.
Results
The cohort was followed for a mean of 5.76 years. Based on the results from the multivariable cause-specific hazard regression model, the adjusted relative rate of experiencing parkinsonism among ADT users compared to non-users was 0.74 (95% confidence interval (CI) 0.67–0.83,
p
< 0.0001). The adjusted relative rate of experiencing the competing event of death among ADT users compared to non-users was 1.33 (95% CI 1.30–1.36,
p
< 0.0001). The 5-year incidence of parkinsonism was 1.03% in ADT users versus 1.56% in non-users.
Conclusion
Contrary to our hypothesis, continuous ADT use for at least 6 months in men with prostate cancer was not associated with an increased risk of parkinsonism after accounting for the substantial competing risk of death.</description><identifier>ISSN: 0724-4983</identifier><identifier>EISSN: 1433-8726</identifier><identifier>DOI: 10.1007/s00345-017-2010-z</identifier><identifier>PMID: 28204918</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Androgen Antagonists - therapeutic use ; Androgens ; Antineoplastic Agents, Hormonal - therapeutic use ; Basal ganglia ; Brain diseases ; Cardiovascular diseases ; Case reports ; Case-Control Studies ; Central nervous system diseases ; Cohort Studies ; Gonadotropin-Releasing Hormone - agonists ; Health risk assessment ; Humans ; Incidence ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Movement disorders ; Multivariate Analysis ; Nephrology ; Oncology ; Ontario - epidemiology ; Orchiectomy ; Original Article ; Parkinson's disease ; Parkinsonian Disorders - epidemiology ; Propensity Score ; Proportional Hazards Models ; Prostate cancer ; Prostatic Neoplasms - therapy ; Risk Factors ; Testosterone ; Urology</subject><ispartof>World journal of urology, 2017-09, Vol.35 (9), p.1417-1423</ispartof><rights>Springer-Verlag Berlin Heidelberg 2017</rights><rights>World Journal of Urology is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-bbd472c4e68e98ef50811cfc37645bbfa8072de116dbf89b840a9853611015203</citedby><cites>FETCH-LOGICAL-c372t-bbd472c4e68e98ef50811cfc37645bbfa8072de116dbf89b840a9853611015203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00345-017-2010-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00345-017-2010-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28204918$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Young, James W. S.</creatorcontrib><creatorcontrib>Sutradhar, Rinku</creatorcontrib><creatorcontrib>Rangrej, Jagadish</creatorcontrib><creatorcontrib>Marras, Connie</creatorcontrib><creatorcontrib>Fleshner, Neil</creatorcontrib><creatorcontrib>Alibhai, Shabbir M. H.</creatorcontrib><title>Androgen deprivation therapy and the risk of parkinsonism in men with prostate cancer</title><title>World journal of urology</title><addtitle>World J Urol</addtitle><addtitle>World J Urol</addtitle><description>Purpose
Case reports and anecdotal experiences suggest that some men develop parkinsonism after initiating androgen deprivation therapy (ADT) for the treatment of prostate cancer, possibly due to neurophysiological effects of changes in testosterone and/or estrogen. We hypothesized that ADT would increase the risk of parkinsonism.
Methods
Using linked administrative databases in Ontario, Canada, men age 40 or older with prostate cancer on continuous ADT for at least 6 months or who underwent bilateral orchiectomy (
n
= 38,931) were matched 1:1 with men with prostate cancer who had never received ADT. Treated and untreated groups were range-matched on age at index date and year of diagnosis, and propensity-matched on comorbidities, medications, cardiovascular risk factors, and socio-economic variables. A competing risk analysis was conducted where the primary outcome was time to a new diagnosis of parkinsonism.
Results
The cohort was followed for a mean of 5.76 years. Based on the results from the multivariable cause-specific hazard regression model, the adjusted relative rate of experiencing parkinsonism among ADT users compared to non-users was 0.74 (95% confidence interval (CI) 0.67–0.83,
p
< 0.0001). The adjusted relative rate of experiencing the competing event of death among ADT users compared to non-users was 1.33 (95% CI 1.30–1.36,
p
< 0.0001). The 5-year incidence of parkinsonism was 1.03% in ADT users versus 1.56% in non-users.
Conclusion
Contrary to our hypothesis, continuous ADT use for at least 6 months in men with prostate cancer was not associated with an increased risk of parkinsonism after accounting for the substantial competing risk of death.</description><subject>Adult</subject><subject>Aged</subject><subject>Androgen Antagonists - therapeutic use</subject><subject>Androgens</subject><subject>Antineoplastic Agents, Hormonal - therapeutic use</subject><subject>Basal ganglia</subject><subject>Brain diseases</subject><subject>Cardiovascular diseases</subject><subject>Case reports</subject><subject>Case-Control Studies</subject><subject>Central nervous system diseases</subject><subject>Cohort Studies</subject><subject>Gonadotropin-Releasing Hormone - agonists</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Movement disorders</subject><subject>Multivariate Analysis</subject><subject>Nephrology</subject><subject>Oncology</subject><subject>Ontario - epidemiology</subject><subject>Orchiectomy</subject><subject>Original Article</subject><subject>Parkinson's disease</subject><subject>Parkinsonian Disorders - epidemiology</subject><subject>Propensity Score</subject><subject>Proportional Hazards Models</subject><subject>Prostate cancer</subject><subject>Prostatic Neoplasms - therapy</subject><subject>Risk Factors</subject><subject>Testosterone</subject><subject>Urology</subject><issn>0724-4983</issn><issn>1433-8726</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kF1LwzAUhoMobk5_gDcS8Mab6jlp2iaXY_gFgjfuOqRtunVb05l0yvbrTdkUEbxK4Dzv-XgIuUS4RYDszgPEPIkAs4gBQrQ7IkPkcRyJjKXHZAgZ4xGXIh6QM-8XEMAUklMyYIIBlyiGZDq2pWtnxtLSrF39obu6tbSbG6fXW6pt2f-pq_2SthVda7esrW9t7RtaW9qE3Gfdzenatb7TnaGFtoVx5-Sk0itvLg7viEwf7t8mT9HL6-PzZPwSFXHGuijPS56xgptUGClMlYBALKpQTHmS55UW4YLSIKZlXgmZCw5aiiROEQETBvGI3Oz7hvnvG-M71dS-MKuVtqbdeIUilZDKXsGIXP9BF-3G2bCdQhknKJmQLFC4p4pwkHemUkFKo91WIajeudo7V0Gl6p2rXchcHTpv8saUP4lvyQFge8CHkp0Z92v0v12_AJPrjCA</recordid><startdate>20170901</startdate><enddate>20170901</enddate><creator>Young, James W. S.</creator><creator>Sutradhar, Rinku</creator><creator>Rangrej, Jagadish</creator><creator>Marras, Connie</creator><creator>Fleshner, Neil</creator><creator>Alibhai, Shabbir M. H.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20170901</creationdate><title>Androgen deprivation therapy and the risk of parkinsonism in men with prostate cancer</title><author>Young, James W. S. ; Sutradhar, Rinku ; Rangrej, Jagadish ; Marras, Connie ; Fleshner, Neil ; Alibhai, Shabbir M. H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-bbd472c4e68e98ef50811cfc37645bbfa8072de116dbf89b840a9853611015203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Androgen Antagonists - therapeutic use</topic><topic>Androgens</topic><topic>Antineoplastic Agents, Hormonal - therapeutic use</topic><topic>Basal ganglia</topic><topic>Brain diseases</topic><topic>Cardiovascular diseases</topic><topic>Case reports</topic><topic>Case-Control Studies</topic><topic>Central nervous system diseases</topic><topic>Cohort Studies</topic><topic>Gonadotropin-Releasing Hormone - agonists</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Movement disorders</topic><topic>Multivariate Analysis</topic><topic>Nephrology</topic><topic>Oncology</topic><topic>Ontario - epidemiology</topic><topic>Orchiectomy</topic><topic>Original Article</topic><topic>Parkinson's disease</topic><topic>Parkinsonian Disorders - epidemiology</topic><topic>Propensity Score</topic><topic>Proportional Hazards Models</topic><topic>Prostate cancer</topic><topic>Prostatic Neoplasms - therapy</topic><topic>Risk Factors</topic><topic>Testosterone</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Young, James W. S.</creatorcontrib><creatorcontrib>Sutradhar, Rinku</creatorcontrib><creatorcontrib>Rangrej, Jagadish</creatorcontrib><creatorcontrib>Marras, Connie</creatorcontrib><creatorcontrib>Fleshner, Neil</creatorcontrib><creatorcontrib>Alibhai, Shabbir M. H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Young, James W. S.</au><au>Sutradhar, Rinku</au><au>Rangrej, Jagadish</au><au>Marras, Connie</au><au>Fleshner, Neil</au><au>Alibhai, Shabbir M. H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Androgen deprivation therapy and the risk of parkinsonism in men with prostate cancer</atitle><jtitle>World journal of urology</jtitle><stitle>World J Urol</stitle><addtitle>World J Urol</addtitle><date>2017-09-01</date><risdate>2017</risdate><volume>35</volume><issue>9</issue><spage>1417</spage><epage>1423</epage><pages>1417-1423</pages><issn>0724-4983</issn><eissn>1433-8726</eissn><abstract>Purpose
Case reports and anecdotal experiences suggest that some men develop parkinsonism after initiating androgen deprivation therapy (ADT) for the treatment of prostate cancer, possibly due to neurophysiological effects of changes in testosterone and/or estrogen. We hypothesized that ADT would increase the risk of parkinsonism.
Methods
Using linked administrative databases in Ontario, Canada, men age 40 or older with prostate cancer on continuous ADT for at least 6 months or who underwent bilateral orchiectomy (
n
= 38,931) were matched 1:1 with men with prostate cancer who had never received ADT. Treated and untreated groups were range-matched on age at index date and year of diagnosis, and propensity-matched on comorbidities, medications, cardiovascular risk factors, and socio-economic variables. A competing risk analysis was conducted where the primary outcome was time to a new diagnosis of parkinsonism.
Results
The cohort was followed for a mean of 5.76 years. Based on the results from the multivariable cause-specific hazard regression model, the adjusted relative rate of experiencing parkinsonism among ADT users compared to non-users was 0.74 (95% confidence interval (CI) 0.67–0.83,
p
< 0.0001). The adjusted relative rate of experiencing the competing event of death among ADT users compared to non-users was 1.33 (95% CI 1.30–1.36,
p
< 0.0001). The 5-year incidence of parkinsonism was 1.03% in ADT users versus 1.56% in non-users.
Conclusion
Contrary to our hypothesis, continuous ADT use for at least 6 months in men with prostate cancer was not associated with an increased risk of parkinsonism after accounting for the substantial competing risk of death.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>28204918</pmid><doi>10.1007/s00345-017-2010-z</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0724-4983 |
| ispartof | World journal of urology, 2017-09, Vol.35 (9), p.1417-1423 |
| issn | 0724-4983 1433-8726 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1869069498 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Androgen Antagonists - therapeutic use Androgens Antineoplastic Agents, Hormonal - therapeutic use Basal ganglia Brain diseases Cardiovascular diseases Case reports Case-Control Studies Central nervous system diseases Cohort Studies Gonadotropin-Releasing Hormone - agonists Health risk assessment Humans Incidence Male Medicine Medicine & Public Health Middle Aged Movement disorders Multivariate Analysis Nephrology Oncology Ontario - epidemiology Orchiectomy Original Article Parkinson's disease Parkinsonian Disorders - epidemiology Propensity Score Proportional Hazards Models Prostate cancer Prostatic Neoplasms - therapy Risk Factors Testosterone Urology |
| title | Androgen deprivation therapy and the risk of parkinsonism in men with prostate cancer |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-08T10%3A35%3A24IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Androgen%20deprivation%20therapy%20and%20the%20risk%20of%20parkinsonism%20in%20men%20with%20prostate%20cancer&rft.jtitle=World%20journal%20of%20urology&rft.au=Young,%20James%20W.%20S.&rft.date=2017-09-01&rft.volume=35&rft.issue=9&rft.spage=1417&rft.epage=1423&rft.pages=1417-1423&rft.issn=0724-4983&rft.eissn=1433-8726&rft_id=info:doi/10.1007/s00345-017-2010-z&rft_dat=%3Cproquest_cross%3E1935192892%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1935192892&rft_id=info:pmid/28204918&rfr_iscdi=true |