Cardiovascular Effects of GnRH Antagonists Compared With Agonists in Prostate Cancer

doi:10.1016/j.jaccao.2023.05.011

Cardio-oncology & otherMeta-analysis

Cardiovascular Effects of Gonadotropin-releasing Hormone (GnRH) Antagonists Compared With Agonists in Prostate Cancer

JACC CardioOncolPublished 1 Aug 2023

Systematic review and Bayesian meta-analysis of randomised trials
random effects
open-label trials
Max trial duration 3 to 36 months (median = 12 months)

Only 1 trial used blinded, adjudicated events; potential bias in all trials (open-label)

Read the original article ↗

Authors' conclusion

Notwithstanding these limitations, the available data suggest that GnRH antagonists are associated with fewer cardiovascular events, and possibly mortality, compared with GnRH agonists.

Study context

Population: Patients with advanced prostate cancer receiving androgen deprivation therapy
Participants: 4,248 patients · 11 RCTs

Comparison: GnRH antagonists vs GnRH agonists
GnRH antagonistsn = 2,655
GnRH agonistsn = 1,593reference
Outcome: MACE:
MI
CNS haemorrhages and cerebrovascular conditions
All-cause mortality
MedDRA terms

Pooled result

As reported in the abstract

Odds ratio

0.57

95% CrI 0.37–0.86

Events by group

GnRH antagonists2.9%76 of 2,655

GnRH agonists4.8%76 of 1,593

GnRH antagonists vs GnRH agonists

OR 0.57 (95% CrI 0.37–0.86)

Further pooled results

Outcome	Lower odds with GnRH antagonists ←→ Higher odds with GnRH antagonists	OR (95% CrI)
All-cause death · CrI		0.58 (0.32–1.08)
	0.20.5125Odds ratio (log scale)

All-cause death: 95% CrI

Original publication

Cardiovascular Effects of GnRH Antagonists Compared With Agonists in Prostate Cancer. JACC CardioOncol. Published 1 August 2023. doi:10.1016/j.jaccao.2023.05.011

Read the original article ↗PubMedCite RIS · BibTeX

Summarised from the published abstract; every number is checked against it