A retrospective analysis of a pharmacovigilance database revealed that men receiving hormone therapy for prostate cancer usually report arterial vascular events. Furthermore, usage of gonadotropin releasing hormone or GnRH antagonists results in fewer overall cardiovascular or CV and arterial vascular events compared with GnRH agonists.
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What is Arterial Vascular Events?
Arterial vascular events, sometimes referred to as artery
disease, is a vascular disease that affects the arteries of your body,
which are the vessels that carry oxygen-rich blood away from your heart to the
tissues of the body. The largest artery in your body is the aorta, which stems
from the heart’s left ventricle and branches out into smaller arteries
throughout the body.
What are the Symptoms of Arterial Disease?
Arterial disease can affect different parts of the
body, from the heart to the kidney to the legs, symptoms range widely. For
example, a coronary artery disease can cause chest pain or a feeling of
pressure in your chest. On the other hand, symptoms of carotid artery disease
may include dizziness, a loss of balance, or a severe headache. While
peripheral arterial disease (PAD), also known as peripheral artery disease, can
cause foot or leg pain, and foot sores or ulcers which are slow to heal.
What is Gonadotropin Releasing Hormone or
GnRH?
A Gonadotropin hormone is made by a part of the brain
called the hypothalamus. Gonadotropin-releasing hormone causes the pituitary
gland in the brain to produce and secrete the hormones luteinizing hormone (LH)
and follicle-stimulating hormone (FSH). In men, these hormones cause the
testicles to make testosterone. In women, they cause the ovaries to make
estrogen and progesterone. Also called GnRH, LH-RH, LHRH, and luteinizing
hormone-releasing hormone.
Researchers looked into the US Food and Drug
Administration Adverse Event Reporting System for cardiovascular adverse event
reports in men with prostate cancer on GnRH agonists, GnRH antagonists,
androgen receptor antagonists, and/or androgen synthesis inhibitors from
January 2000 to April 2020.
Cardiovascular or CV events comprised 6,231 reports or
about 12.6% on hormone monotherapy and 1,793 reports or 26.1% on combination
therapy. Most reported cardiovascular or CV event was arterial vascular events,
followed by arrhythmias, heart failure, and venous thromboembolism.
The GnRH antagonists associated with fewer
cardiovascular adverse event reports as monotherapy and as combination therapy,
which was driven by reductions in arterial vascular events, than GnRH agonists.
Moreover, the second-generation androgen receptor
antagonists and abiraterone associated with more reports of hypertension requiring
hospitalization and more heart failure events when used in combination with
GnRH antagonists.
Researchers said that additional study is needed to identify
optimal strategies to reduce cardiovascular morbidity among men with prostate
cancer receiving hormone therapy.
Source: J Urol 2021;206:613-622