Cardiovascular Risks and Survival with Abiraterone vs Enzalutamide in Chemotherapy-Naïve Metastatic Castration-Resistant Prostate Cancer in Germany: AVENGER Study
Notice bibliographique
Résumé
Recent real-world studies compared effectiveness and safety of enzalutamide (ENZA) and abiraterone acetate (AA) for metastatic castration-resistant prostate cancer (mCRPC). The growing evidence needs further substantiation with long-term data. This study, the first to use German data, investigated cardiovascular (CV) event risk and overall survival (OS) in patients initiating ENZA or AA. AA (2012) and ENZA (2014) are widely used for mCRPC in Germany. This retrospective study used data of chemotherapy-naïve patients with mCRPC on ENZA or AA (2012–2020) from two German claims databases (AOK PLUS and GWQ ServicePlus). The primary endpoint was time to first CV event (CV-related hospitalization) analyzed via a meta-analysis of Cox proportional hazard models of propensity score-matched (PSM) intention-to-treat cohorts. Other endpoints were baseline characteristics, CV event rate, number of CV events per patient, and OS. Of 2240 patients in the total study population (ENZA, 828; AA, 1412), 796 PSM patients were included in each group. ENZA patients were older and had a higher prevalence of some comorbidities, but without meaningful differences after PSM. Further, 386 patients had ≥ 1 CV event (ENZA, 172; AA, 214). ENZA was associated with a significantly lower risk of CV events (hazard ratio [HR] 0.70, 95% confidence interval [CI] 0.57–0.86, p = 0.001, I2 = 0.0%), CV event rate (0.17 vs 0.23 per person-year; event rate ratio 0.75, 95% CI 0.61–0.92, p = 0.006; I2 = 38.0%), fewer recurrent CV events (HR 0.77, 95% CI 0.61–0.96, p = 0.024; I2 = 0.0%), and prolonged OS (HR 0.79, 95% CI 0.71–0.89, p < 0.001) than AA. The unmatched ENZA cohort had higher average age and more comorbidities than the AA cohort, but no meaningful differences were noted after PSM. ENZA was associated with a significantly lower risk of CV events and improved OS. This study looked at two treatments for a type of advanced prostate cancer in German patients. The treatments are called enzalutamide (ENZA) and abiraterone acetate (AA). We wanted to see which treatment was safer and more effective, especially in terms of heart-related problems and overall survival. We looked at data from patients who had not received chemotherapy and were treated with either ENZA or AA between 2012 and 2020. We compared the time it took for the first heart-related problem to occur in these patients. We also looked at the number of heart-related problems per each patient and overall survival. The study included 2240 patients (828 treated with ENZA and 1412 treated with AA). An early evaluation found that patients treated with ENZA were older and had a higher prevalence of other health problems. However, after matching the patients in each group based on certain characteristics, we found that these differences were not meaningful. Our results showed that a total of 386 patients had at least one heart-related problem after starting on ENZA or AA. We found that patients treated with ENZA had a lower risk of heart-related problems and lived longer than those treated with AA. In conclusion, even though patients treated with ENZA were older and had more health problems, they had a lower risk of heart-related problems.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».