Have we mis-PRONOUNCEd the cardiovascular risk of GnRH agonists? A critical appraisal of the PRONOUNCE trial

Author(s):  
Raj Tiwari ◽  
Katherine Lajkosz ◽  
Neil Fleshner ◽  
Christopher J. D. Wallis
Author(s):  
P.L. Palatty ◽  
A.R. Shivashankara ◽  
J.J. Dsouza ◽  
N. Mathew ◽  
R. Haniadka ◽  
...  

2021 ◽  
Author(s):  
Patrick Davey ◽  
Kyriacos Alexandrou

Abstract Background: Cardiovascular disease (CVD) is a common co-morbidity in patients with prostate cancer. In this review, we summarise the published literature on the association of cardiovascular risk with androgen deprivation therapy (ADT) treatment and explore the potential differences between the gonadotropin-releasing hormone (GnRH) agonists and antagonists and the molecular mechanisms that may be involved. We also provide a practical outlook on the identification of underlying CV risk and explore the different stratification tools available. Results: While not definitive, the current evidence suggests that GnRH antagonists may be associated with lower rates of certain CV events vs agonists, particularly in patients with pre-existing CVD. We have reached this conclusion as the highest-grade evidence from randomised clinical trials comparing GnRH agonists verses antagonists is uniform in finding lower CV event rates with GnRH antagonists. Risk reduction strategies such as lifestyle advice, consideration of ADT modality, and co-medications may help to reduce CV risk factors and improve outcomes in prostate cancer patients receiving ADT. Conclusions: Given all the data that is currently available, identification of baseline CV risk factors may be key to risk mitigation in patients with prostate cancer receiving ADT.


2007 ◽  
Vol 37 (2) ◽  
pp. 90-98 ◽  
Author(s):  
R. P. F. Dullaart ◽  
G. M. Dallinga-Thie ◽  
B. H. R. Wolffenbuttel ◽  
A. van Tol

2016 ◽  
Vol 20 (4) ◽  
pp. 418 ◽  
Author(s):  
AwadheshKumar Singh ◽  
Ritu Singh

2020 ◽  
Vol Volume 16 ◽  
pp. 393-401 ◽  
Author(s):  
Valentina Perrone ◽  
Luca Degli Esposti ◽  
Elisa Giacomini ◽  
Chiara Veronesi ◽  
Valerio Blini ◽  
...  

2014 ◽  
Vol 51 (5) ◽  
pp. 263-279 ◽  
Author(s):  
Magdalena Krintus ◽  
Marek Kozinski ◽  
Jacek Kubica ◽  
Grazyna Sypniewska

2019 ◽  
Vol 495 ◽  
pp. 467-475 ◽  
Author(s):  
Jorge Díaz-Garzón ◽  
Pilar Fernández–Calle ◽  
Joana Minchinela ◽  
Aasne K. Aarsand ◽  
William A. Bartlett ◽  
...  

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