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- W2222030272 abstract "Androgen deprivation therapy (ADT) is the cornerstone therapy in advanced prostate cancer management. Currently, to study cardiovascular risk, many studies pooled ADT modalities, sometimes with orchiectomy. Our objective was to compare the coronary and cerebrovascular risk (myocardial infarction, ischemic stroke) and the cardiovascular and overall mortality across the different ADT modalities. CRD42014010598. We performed a literature search of randomized controlled trials (RCTs) and observational studies using Medline and Embase since 1950 to July 28, 2014, without language restriction provided that they gave data on prostate cancer patients comparing one ADT modality to another or radiotherapy or total prostatectomy or placebo. ADT modalities were GnRH agonists, GnRH antagonists, antiandrogens (steroidal or nonsteroidal), and newer drugs (abiraterone, enzalutamide). Orchiectomy was the relevant alternative. For observational studies pooling several ADT modalities, details on each ADT group were requested to the author. We will also perform a network meta-analysis including RCTs. Among 3614 abstracts, 47 cohorts fulfilled inclusion criteria and 8 provided sufficient data to be analysed. One study gave details on cardiovascular death and 2 on only coronary and cerebrovascular risk, but cardiovascular events definition were too heterogeneous to be pooled (one study added arrhythmia and heart failure to ischemic heart disease). For the 6 other studies, as they did not compare the same modalities of ADT, they were not meta-analysed for overall survival. A total of 153 abstracts mentioning RCT fulfilled inclusion criteria, and data analysis is ongoing. Data from observational studies did not support consistent evidence that any particular ADT modality may increase cardiovascular risk or overall survival. We are conducting a nationwide population-based prospective cohort of 4 years thanks to the French Health Reimbursement Agency database, which allowed us to investigate more in depth the association between different ADT modalities and cardiovascular risk." @default.
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- W2222030272 date "2015-08-01" @default.
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- W2222030272 title "Cardiovascular risk and androgen deprivation therapy for prostate cancer: systematic review and meta-analysis of randomised controlled trials and observational studies (METADTCR)" @default.
- W2222030272 doi "https://doi.org/10.1016/j.clinthera.2015.05.017" @default.
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