Prevalence of Cardiovascular Disease and Osteoporosis During Androgen Deprivation Therapy Prescription Discordant to EAU Guidelines: Results From a Multicenter, Cross-sectional Analysis From the CHOsIng Treatment for Prostate canCEr (CHOICE) Study

Morgia, Giuseppe; Russo, Giorgio Ivan; Tubaro, Andrea; Bortolus, Roberto; Randone, D. F.; Gabriele, P.; Trippa, Fabio; Zattoni, Filiberto; Porena, Massimo; Mirone, Vincenzo; Serni, Sergio; Nero, A. Del; Lay, Giancarlo; Ricardi, Umberto; Rocco, Francesco; Terrone, Carlo; Pagliarulo, Arcangelo; Ludovico, Giuseppe Mario; Vespasiani, Giuseppe; Brausi, Maurizio; Simeone, Claudio; Novella, Giovanni; Carmignani, G.; Leonardi, Rosario; Pinnarò, Paola; Paula, Ugo De; Corvò, Renzo; Tenaglia, R.; Siracusano, Salvatore; Mantini, Giovanna; Savoca, G.; Ficarra, Vincenzo

doi:10.1016/j.urology.2016.06.024

Cited by 22 publications

(22 citation statements)

References 22 publications

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“…One cross-sectional study in Italy concluded that inappropriate ADT was associated with increased risks of cardiovascular disease and osteoporosis [30]. A meta-analysis reported that patients with intermittent ADT had a lower risk of cardiovascular-related mortality [31].…”

Section: Discussionmentioning

confidence: 99%

Patients receiving androgen deprivation therapy for prostate cancer have an increased risk of depressive disorder

et al. 2017

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Androgen deprivation therapy (ADT) results in testosterone suppression, a hypothesized mechanism linking ADT to depressive symptoms. This study investigated the relationship between ADT and the risk of subsequently being diagnosed with depressive disorder (DD) during a 3-year follow-up period. The patient sample for this population-based, retrospective cohort study was retrieved from the Taiwan Longitudinal Health Insurance Database 2005. We included all 1714 patients aged over 40 years with a first-time diagnosis of prostate cancer (PC) during 2001 to 2010 who did not have an orchiectomy. Among them, we defined 868 patients who received ADT during the 3-year follow-up period as the study group, and 846 patients who did not receive ADT as the comparison group. The incidence rates of DD per 1000 person-years were 13.9 (95% confidence interval (CI): 9.5~19.6) and 6.7 (95% CI: 3.7~11.0), respectively. Cox proportional hazard regressions showed that the adjusted hazard ratio for DD for ADT recipients was 1.93 (95% CI: 1.03~3.62) relative to the comparison group. This study presents epidemiological evidence of an association between ADT and a subsequent DD diagnosis.

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Section: Discussionmentioning

confidence: 99%

Patients receiving androgen deprivation therapy for prostate cancer have an increased risk of depressive disorder

et al. 2017

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“…Cardiovascular diseases present as systemic vascular lesions in clinical patients, and are the frequent causes of mortality in the adult population of economically developed countries ( 35 , 36 ). Ischemia-reperfusion injury is one of the most common coronary heart diseases and may further develop into coronary atherosclerosis heart disease, coronary arterial atherosclerosis, or vascular cavity stenosis or occlusion ( 37 , 38 ).…”

Section: Discussionmentioning

confidence: 99%

Berberine inhibits the ischemia‑reperfusion injury induced inflammatory response and apoptosis of myocardial cells through the phosphoinositide 3‑kinase/RAC‑α serine/threonine‑protein kinase and nuclear factor-κB signaling pathways

Wang

Xue

et al. 2017

Exp Ther Med

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Myocardial ischemia-reperfusion injury is one of the most common cardiovascular diseases, and can lead to serious damage and dysfunction of the myocardial tissue. Previous studies have demonstrated that berberine exhibits ameliorative effects on cardiovascular disease. The present study further investigated the efficacy and potential mechanism underlying the effects of berberine on ischemia-reperfusion injury in a mouse model. Inflammatory markers were measured in the serum and levels of inflammatory proteins in myocardial cells were investigated after treatment with berberine. In addition, the apoptosis of myocardial cells was investigated after berberine treatment. Apoptosis-associated gene expression levels and apoptotic signaling pathways were analyzed in myocardial cells after treatment with berberine. The phosphoinositide 3-kinase (PI3K)/RAC-α serine/threonine-protein kinase (AKT) and nuclear factor (NF)-κB signaling pathways were also analyzed in myocardial cells after treatment with berberine. Histological analysis was used to analyze the potential benefits of berberine in ischemia-reperfusion injury. The present study identified that inflammatory responses and inflammatory factors were decreased in the myocardial cells of the mouse model of ischemia-reperfusion injury. Mechanism analysis demonstrated that berberine inhibited apoptotic protease-activating factor 1, caspase-3 and caspase-9 expression in myocardial cells. The expression of Bcl2-associated agonist of cell death, Bcl-2-like protein 1 and cellular tumor antigen p53 was upregulated. Expression of NF-κB p65, inhibitor of NF-κB kinase subunit β (IKK-β), NF-κB inhibitor α (IκBα), and NF-κB activity, were inhibited in myocardial cells in the mouse model of ischemia-reperfusion injury. In conclusion, the results of the present study indicate that berberine inhibits inflammatory responses through the NF-κB signaling pathway and suppresses the apoptosis of myocardial cells via the PI3K/AKT signaling pathway in a mouse model of ischemia-reperfusion injury. These results suggest that berberine is a potential drug for the treatment of patients with ischemia-reperfusion injury.

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“…Observational studies have shown that BMD testing and osteoporosis treatment are sub-optimal in PCa patients on ADT [65]. Given the detrimental effects of fragility fractures and the evidence of a high proportion of inappropriate ADT in PCa [66], DXA scans of PCa patients should become routine medical practice, before, during and after ADT. There are two reasons for this suggestion: the underestimated recognition of osteoporosis among PCa patients is reversible with educational strategies [67]; antiosteoporotic drugs (e.g.…”

Section: Intra-group Comparisonmentioning

confidence: 99%

Osteoporosis and Bone Metabolism in Treatment-naive Primary Prostate Adenocarcinoma Patients

Bojincă¹,

Popescu²,

Bălănescu³

et al. 2018

Rev. Chim.

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The objectives of the study were to evaluate bone metabolism in primary prostate cancer (PCa) patients prior to any treatment and to compare estrogens and anti-androgens in terms of bone metabolism. The study prospectively included consecutive patients with primary PCa who were proposed for radical prostatectomy and androgen deprivation therapy (ADT; either estrogens-group E, or anti-androgens -group A) and age-matched controls. Bone markers (osteoprotegerin -OPG; osteocalcin; deoxypyridinoline) were measured before treatment and after 6 months. Bone mineral density (BMD) was measured by dual X-ray absorptiometry before treatment and after 12 months (osteoporosis was defined as a spine or hip T score � -2.5). Continuous variables are reported as mean � standard deviation. The study included 30 controls (aged 70 � 6 years), 15 patients treated with estrogens (aged 71 � 6 years) and 15 patients with anti-androgens (aged 72 � 5 years). At baseline, 0% of controls, 33.3% of group E (p = 0.002 versus controls) and 53.3% of group A (p = 0.0001 versus controls) had osteoporosis. In group E, compared to baseline, OPG (4.67 � 1.38 versus 5.27 � 1.89; p = 0.043) and DPD (6.85 � 3.24 versus 8.63 � 2.42; p = 0.008) increased, while spine (0.99 � 0.32 versus 0.94 � 0.31; p = 0.019) BMD decreased. In group A, compared to baseline, OPG (6.37 � 3.04 versus 5.02 � 1.12; p = 0.041), spine (1.03 � 0.15 versus 0.89 � 0.15; p = 0.0003) and hip (0.82 � 0.18 versus 0.75 � 0.17; p = 0.003) BMD decreased. Osteoporosis is prevalent among hormone-na�ve PCa patients. Estrogens are associated with an increase of serum OPG, while anti-androgens with a decrease of serum OPG. Irrespective of ADT type, BMD still decreases in primary PCa patients.

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Prevalence of Cardiovascular Disease and Osteoporosis During Androgen Deprivation Therapy Prescription Discordant to EAU Guidelines: Results From a Multicenter, Cross-sectional Analysis From the CHOsIng Treatment for Prostate canCEr (CHOICE) Study

Cited by 22 publications

References 22 publications

Patients receiving androgen deprivation therapy for prostate cancer have an increased risk of depressive disorder

Patients receiving androgen deprivation therapy for prostate cancer have an increased risk of depressive disorder

Berberine inhibits the ischemia‑reperfusion injury induced inflammatory response and apoptosis of myocardial cells through the phosphoinositide 3‑kinase/RAC‑α serine/threonine‑protein kinase and nuclear factor-κB signaling pathways

Osteoporosis and Bone Metabolism in Treatment-naive Primary Prostate Adenocarcinoma Patients

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