Do Abiraterone or Enzalutamide Increase Risk for Metabolic and Cardiovascular Events?

Although androgen deprivation therapy (ADT) is the cornerstone for the systemic management of advanced prostate cancer, there is an associated elevated risk for both metabolic syndrome and major cardiovascular events. Abiraterone and enzalutamide are widely used in advanced prostate cancer based on evidence of survival benefit. To examine their safety in routine practice, investigators assessed the occurrence of metabolic and cardiovascular events in a random sample of 20% of Medicare beneficiaries from 2010–2017.

The primary outcome was a composite measure of major metabolic and cardiac events, defined as an emergency room visit or hospitalization associated with a primary diagnosis of diabetes, hypertension, or cardiovascular disease. A se…