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World Journal of Urology

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01-09-2017 | Original Article

Androgen deprivation therapy and the risk of parkinsonism in men with prostate cancer

Authors: James W. S. Young, Rinku Sutradhar, Jagadish Rangrej, Connie Marras, Neil Fleshner, Shabbir M. H. Alibhai

Published in: World Journal of Urology | Issue 9/2017

Abstract

Purpose

Case reports and anecdotal experiences suggest that some men develop parkinsonism after initiating androgen deprivation therapy (ADT) for the treatment of prostate cancer, possibly due to neurophysiological effects of changes in testosterone and/or estrogen. We hypothesized that ADT would increase the risk of parkinsonism.

Methods

Using linked administrative databases in Ontario, Canada, men age 40 or older with prostate cancer on continuous ADT for at least 6 months or who underwent bilateral orchiectomy (n = 38,931) were matched 1:1 with men with prostate cancer who had never received ADT. Treated and untreated groups were range-matched on age at index date and year of diagnosis, and propensity-matched on comorbidities, medications, cardiovascular risk factors, and socio-economic variables. A competing risk analysis was conducted where the primary outcome was time to a new diagnosis of parkinsonism.

Results

The cohort was followed for a mean of 5.76 years. Based on the results from the multivariable cause-specific hazard regression model, the adjusted relative rate of experiencing parkinsonism among ADT users compared to non-users was 0.74 (95% confidence interval (CI) 0.67–0.83, p < 0.0001). The adjusted relative rate of experiencing the competing event of death among ADT users compared to non-users was 1.33 (95% CI 1.30–1.36, p < 0.0001). The 5-year incidence of parkinsonism was 1.03% in ADT users versus 1.56% in non-users.

Conclusion

Contrary to our hypothesis, continuous ADT use for at least 6 months in men with prostate cancer was not associated with an increased risk of parkinsonism after accounting for the substantial competing risk of death.

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Title: Androgen deprivation therapy and the risk of parkinsonism in men with prostate cancer
Authors: James W. S. Young
Rinku Sutradhar
Jagadish Rangrej
Connie Marras
Neil Fleshner
Shabbir M. H. Alibhai
Publication date: 01-09-2017
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 9/2017
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-017-2010-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Androgen deprivation therapy and the risk of parkinsonism in men with prostate cancer

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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