Supervised exercise therapy compared with no exercise therapy to reverse debilitating effects of androgen deprivation therapy in patients with prostate cancer: a systematic review and meta-analysis

Ussing, Anja; Mikkelsen, Marie-Louise Kirkegaard; Villumsen, Brigitta R; Wejlgaard, Johnny; Bistrup, Pernille Envold; Birkefoss, Kirsten; Bandholm, Thomas

doi:10.1038/s41391-021-00450-0

Cited by 14 publications

(21 citation statements)

References 65 publications

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“…Perhaps unsurprisingly, emerging evidence has suggested that exercise might exert a positive effect on the components of GI microbiota ( 41 ). The results of a meta-analysis included 14 RCTs supported a strong recommendation for supervised exercise therapy for improving disease-specific quality of life in patients receiving ADT ( 42 ). Excitedly, an ongoing single-blinded, two-armed, RCT was designed to explore the influence of a 3-month exercise program (3 days/week) for gut health in men receiving ADT ( 37 ).…”

Section: Discussionmentioning

confidence: 93%

Association of Novel Androgen Receptor Axis-Targeted Therapies With Diarrhea in Patients With Prostate Cancer: A Bayesian Network Analysis

Xiong

Wang

et al. 2022

Front. Med.

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ObjectiveTo perform a systematic review and network meta-analysis to characterize the effect of novel androgen receptor axis-target (ARAT) agents on diarrhea and constipation.MethodsWe searched the Pubmed, Web of Science, and ClinicalTrials.gov up to September 2021 for phase 3 randomized controlled trials (RCTs) of patients receiving novel ARAT agents for prostate cancer (CaP). A Cochrane risk-of-bias tool was used to assess trial quality. The primary outcomes were risk ratio (RR) of any-grade diarrhea and constipation for patients receiving ARAT treatment. RRs of competing treatments were evaluated by pairwise and Bayesian network meta-analysis.ResultsIn this study, 13 trials with 15,117 participants comparing 5 treatments (abiraterone, enzalutamide, apalutamide, darolutamide, and placebo) were identified. Use of novel ARAT agents was associated with a significant increased risk of any-grade diarrhea (RR = 1.30, 95% CI [1.16, 1.44]). As for subgroup analysis, abiraterone, enzalutamide, and apalutamide were all associated with significant increased risk of any-grade diarrhea (abiraterone: RR = 1.40, 95% CI [1.09, 1.81]; enzalutamide: RR = 1.17, 95% CI [1.02, 1.35]; apalutamide: RR = 1.35, 95% CI [1.03, 1.76]). Based on Bayesian modeling, abiraterone and enzalutamide showed the highest and lowest probability to rank first in terms of increasing risk of any-grade diarrhea. There were no significant differences of risk in any-grade constipation, grade 3 or greater diarrhea, and constipation between ARAT and control group.ConclusionThe present study indicates that the use of novel ARAT agents is associated with a significantly higher risk of diarrhea. Across the four agents, abiraterone may relate to the highest risk of diarrhea among patients with metastatic hormone sensitive prostate cancer (mHSPC) and castration-resistant prostate cancer (CRPC).

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Section: Discussionmentioning

confidence: 93%

Association of Novel Androgen Receptor Axis-Targeted Therapies With Diarrhea in Patients With Prostate Cancer: A Bayesian Network Analysis

Xiong

Wang

et al. 2022

Front. Med.

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“…Although the effect of HIIT application in different periods is unclear, according to the current research, the early use of exercise intervention may not affect the progression of prostate cancer [ 51 ]. However, the use of exercise intervention in any period can yield certain benefits, especially in the advanced stage, and the use of exercise intervention can significantly improve the quality of life, walking ability, and mortality of patients [ 52 , 53 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of high-intensity interval training on aerobic capacity and fatigue among patients with prostate cancer: a meta-analysis

et al. 2022

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Objective This study focused on evaluating whether high-intensity interval training (HIIT) had an effect on aerobic capacity and fatigue among patients with prostate cancer (PCa) and exploring its effect on the immune system of PCa patients. Methods To investigate the potential effect of HIIT on patients with prostate cancer, a meta-analysis was carried out. From January 2012 to August 2022, studies that met predefined criteria were searched in the Scopus, PubMed, Web of Science, and EBSCO databases. Analysis of the standardized mean differences was performed using Review Manager 5.4.1 software with a 95% confidence interval. Results This review examined a total of 6 articles. There were 215 male patients with PCa involved, and the mean age was 64.4 years. According to the results of the meta-analysis, the HIIT group (n = 63) had greater VO2peak (P<0.01) than the control group (CON) (n = 52) (P = 0.30, I2 = 19% in the heterogeneity test; MD, 1.39 [0.50, 2.27]). Moreover, fatigue was significantly different (P<0.01) between the HIIT (n = 62) and CON (n = 61) groups (P = 0.78, I2 = 0% in the heterogeneity test; SMD, −0.52 [−0.88, −0.16]). Furthermore, among PCa patients, HIIT showed higher efficacy (P < 0.01) in decreasing PSA than the CON regimen (P=0.22, I2 = 34% in the heterogeneity test; MD, −1.13 [−1.91, −0.34]). Conclusions HIIT improves aerobic capacity, fatigue, and PSA levels among PCa patients but does not significantly affect IL-6 or TNF-α content. Therefore, HIIT may be a novel and potent intervention scheme for PCa patients.

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“…The methodology used in the Danish Health Authority guideline development has previously been described [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ]. In short, the methodology is based on the recommendations for conducting systematic reviews and meta-analyses from the Cochrane Handbook for systematic reviews [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Cochrane Reviews in Clinical Guideline Development—A Survey of 585 Recommendations

Korfitsen

Mikkelsen

Ussing

et al. 2022

IJERPH

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The Danish Health Authority develops clinical practice guidelines to support clinical decision-making based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and prioritizes using Cochrane reviews. The objective of this study was to explore the usefulness of Cochrane reviews as a source of evidence in the development of clinical recommendations. Evidence-based recommendations in guidelines published by the Danish Health Authority between 2014 and 2021 were reviewed. For each recommendation, it was noted if and how Cochrane reviews were utilized. In total, 374 evidence-based recommendations and 211 expert consensus recommendations were published between 2014 and 2021. Of the 374 evidence-based recommendations, 106 included evidence from Cochrane reviews. In 28 recommendations, all critical and important outcomes included evidence from Cochrane reviews. In 36 recommendations, a minimum of all critical outcomes included evidence from Cochrane reviews, but not all important outcomes. In 33 recommendations, some but not all critical outcomes included evidence from Cochrane reviews. Finally, in nine recommendations, some of the important outcomes included evidence from Cochrane reviews. In almost one-third of the evidence-based recommendations, Cochrane reviews were used to inform clinical recommendations. This evaluation should inform future evaluations of Cochrane review uptake in clinical practice guidelines concerning outcomes important for clinical decision-making.

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Supervised exercise therapy compared with no exercise therapy to reverse debilitating effects of androgen deprivation therapy in patients with prostate cancer: a systematic review and meta-analysis

Cited by 14 publications

References 65 publications

Association of Novel Androgen Receptor Axis-Targeted Therapies With Diarrhea in Patients With Prostate Cancer: A Bayesian Network Analysis

Association of Novel Androgen Receptor Axis-Targeted Therapies With Diarrhea in Patients With Prostate Cancer: A Bayesian Network Analysis

Effect of high-intensity interval training on aerobic capacity and fatigue among patients with prostate cancer: a meta-analysis

Usefulness of Cochrane Reviews in Clinical Guideline Development—A Survey of 585 Recommendations

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