This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Gonadotropin releasing hormone agonists (GnRH agonists) and cardiovascular (CV) risk in prostate cancer

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

In a cohort study of 5714 men with prostate cancer (PCa) and 28 445 men without PCa, men with type 2 diabetes and PCa who received a gonadotropin releasing hormone agonists (GnRH) agonist had 53% higher risk of an increase in CVD risk compared with men with type 2 diabetes and PCa who did not receive a GnRH agonist (1):

  • primary outcomes of the study were 10% or 5% increase in predicted 5-year CVD risk score, which was estimated by use of a CVD risk model
  • Men with PCa receiving GnRH agonists had an increased estimated 5-year CVD risk score compared with men without PCa (hazard ratio [HR], 1.25; 95% CI, 1.16-1.36) and compared with men with PCa not receiving GnRH agonists (HR, 1.53; 95% CI, 1.35-1.74)
  • men receiving GnRH agonists had decreased blood pressure compared with men without PCa (HR, 0.70; 95% CI, 0.61-0.80) and compared with men with PCa not receiving GnRH agonists (HR, 0.68; 95% CI, 0.56-0.82)
  • study authors stated that population-based cohort study, there was an increased risk of CVD in men with type 2 diabetes who received a GnRH agonist for PCa

Androgen deprivation therapy (ADT) and specifically GnRH agonists, have been associated with increased cardiovascular (CV) morbidity and mortality in observational studies, and men with pre-existing CVD are most at risk (2)

An analysis of real-world data from the UK primary care setting showed that relative risk of experiencing cardiac events was significantly lower with degarelix, a GnRH antagonist, compared with GnRH agonists (risk ratio: 0.39 [95% confidence interval 0.191, 0.799]; p = 0.01) (3):

  • study authors concluded:
    • "..available data suggests that GnRH agonists increase CV events, and this effect appears to be greatest in patients with pre-existing CVD, and GnRH antagonists may be associated with lower rates of certain CV events vs GnRH agonists, particularly in patients with pre-existing CVD. The results in the present study support the hypothesis that the risk of cardiac events may be lower in patients receiving a GnRH antagonist such as degarelix, compared with GnRH agonists..."

 

Reference:

  1. Lin E, Garmo H, Van Hemelrijck M, et al. Association of Gonadotropin-Releasing Hormone Agonists for Prostate Cancer With Cardiovascular Disease Risk and Hypertension in Men With Diabetes. JAMA Netw Open. 2022;5(8):e2225600. doi:10.1001/jamanetworkopen.2022.25600
  2. O'Farrell S, Garmo H, Holmberg L, Adolfsson J, Stattin P, Van Hemelrijck M. Risk and timing of cardiovascular disease after androgen-deprivation therapy in men with prostate cancer. J Clin Oncol. 2015 Apr 10;33(11):1243-51
  3. Davey P, Kirby MG. Cardiovascular risk profiles of GnRH agonists and antagonists: real-world analysis from UK general practice. World J Urol. 2021 Feb;39(2):307-315. doi: 10.1007/s00345-020-03433-3. Epub 2020 Sep 26. Erratum in: World J Urol. 2022 Jun;40(6):1603.

Related pages

Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.