Impact of androgen deprivation therapy on mortality of prostate cancer patients with COVID-19: a propensity score-based analysis

Abstract Background Previous studies hypothesized that androgen deprivation therapy (ADT) may reduce severe acute respiratory syndrome coronavirus 2 (SARS-COV2) infectivity. However, it is unknown whether there is an association between ADT and a higher survival in prostate cancer patients with COVI...

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Autores principales:	Mateus Bringel Oliveira Duarte, Frederico Leal, Juliana Luz Passos Argenton, José Barreto Campello Carvalheira
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	COVID-19 Androgen antagonists Androgen receptor antagonists Antineoplastic agents Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/48f4d7b0b31341858bb6a0c56b2d68d3
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spelling	oai:doaj.org-article:48f4d7b0b31341858bb6a0c56b2d68d32021-11-28T12:11:22ZImpact of androgen deprivation therapy on mortality of prostate cancer patients with COVID-19: a propensity score-based analysis10.1186/s13027-021-00406-y1750-9378https://doaj.org/article/48f4d7b0b31341858bb6a0c56b2d68d32021-11-01T00:00:00Zhttps://doi.org/10.1186/s13027-021-00406-yhttps://doaj.org/toc/1750-9378Abstract Background Previous studies hypothesized that androgen deprivation therapy (ADT) may reduce severe acute respiratory syndrome coronavirus 2 (SARS-COV2) infectivity. However, it is unknown whether there is an association between ADT and a higher survival in prostate cancer patients with COVID-19. Methods We performed a retrospective analysis of prostate cancer (PC) patients hospitalized to treat COVID-19 in Brazil’s public health system. We compared patients with the active use of ADT versus those with non-active ADT, past use. We constructed propensity score models of patients in active versus non-active use of ADT. All variables were used to derive propensity score estimation in both models. In the first model we performed a pair-matched propensity score model between those under active and non-active use of ADT. To the second model we initially performed a multivariate backward elimination process to select variables to a final inverse-weight adjusted with double robust estimation model. Results We analyzed 199 PC patients with COVID-19 that received ADT. In total, 52.3% (95/199) of our patients were less than 75 years old, 78.4% (156/199) were on active ADT, and most were using a GnRH analog (80.1%; 125/156). Most of patients were in palliative treatment (89.9%; 179/199). Also, 63.3% of our cohort died from COVID-19. Forty-eight patients under active ADT were pair matched against 48 controls (non-active ADT). All patients (199) were analyzed in the double robust model. ADT active use were not protective factor in both inverse-weight based propensity score (OR 0.70, 95% CI 0.38–1.31, P = 0.263), and pair-matched propensity score (OR 0.67, 95% CI 0.27–1.63, P = 0.374) models. We noticed a significant imbalance in the propensity score of patients in active and those in non-active ADT, with important reductions in the differences after the adjustments. Conclusions The active use of ADT was not associated with a reduced risk of death in patients with COVID-19.Mateus Bringel Oliveira DuarteFrederico LealJuliana Luz Passos ArgentonJosé Barreto Campello CarvalheiraBMCarticleCOVID-19Androgen antagonistsAndrogen receptor antagonistsAntineoplastic agentsNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282Infectious and parasitic diseasesRC109-216ENInfectious Agents and Cancer, Vol 16, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 Androgen antagonists Androgen receptor antagonists Antineoplastic agents Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Infectious and parasitic diseases RC109-216
spellingShingle	COVID-19 Androgen antagonists Androgen receptor antagonists Antineoplastic agents Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Infectious and parasitic diseases RC109-216 Mateus Bringel Oliveira Duarte Frederico Leal Juliana Luz Passos Argenton José Barreto Campello Carvalheira Impact of androgen deprivation therapy on mortality of prostate cancer patients with COVID-19: a propensity score-based analysis
description	Abstract Background Previous studies hypothesized that androgen deprivation therapy (ADT) may reduce severe acute respiratory syndrome coronavirus 2 (SARS-COV2) infectivity. However, it is unknown whether there is an association between ADT and a higher survival in prostate cancer patients with COVID-19. Methods We performed a retrospective analysis of prostate cancer (PC) patients hospitalized to treat COVID-19 in Brazil’s public health system. We compared patients with the active use of ADT versus those with non-active ADT, past use. We constructed propensity score models of patients in active versus non-active use of ADT. All variables were used to derive propensity score estimation in both models. In the first model we performed a pair-matched propensity score model between those under active and non-active use of ADT. To the second model we initially performed a multivariate backward elimination process to select variables to a final inverse-weight adjusted with double robust estimation model. Results We analyzed 199 PC patients with COVID-19 that received ADT. In total, 52.3% (95/199) of our patients were less than 75 years old, 78.4% (156/199) were on active ADT, and most were using a GnRH analog (80.1%; 125/156). Most of patients were in palliative treatment (89.9%; 179/199). Also, 63.3% of our cohort died from COVID-19. Forty-eight patients under active ADT were pair matched against 48 controls (non-active ADT). All patients (199) were analyzed in the double robust model. ADT active use were not protective factor in both inverse-weight based propensity score (OR 0.70, 95% CI 0.38–1.31, P = 0.263), and pair-matched propensity score (OR 0.67, 95% CI 0.27–1.63, P = 0.374) models. We noticed a significant imbalance in the propensity score of patients in active and those in non-active ADT, with important reductions in the differences after the adjustments. Conclusions The active use of ADT was not associated with a reduced risk of death in patients with COVID-19.
format	article
author	Mateus Bringel Oliveira Duarte Frederico Leal Juliana Luz Passos Argenton José Barreto Campello Carvalheira
author_facet	Mateus Bringel Oliveira Duarte Frederico Leal Juliana Luz Passos Argenton José Barreto Campello Carvalheira
author_sort	Mateus Bringel Oliveira Duarte
title	Impact of androgen deprivation therapy on mortality of prostate cancer patients with COVID-19: a propensity score-based analysis
title_short	Impact of androgen deprivation therapy on mortality of prostate cancer patients with COVID-19: a propensity score-based analysis
title_full	Impact of androgen deprivation therapy on mortality of prostate cancer patients with COVID-19: a propensity score-based analysis
title_fullStr	Impact of androgen deprivation therapy on mortality of prostate cancer patients with COVID-19: a propensity score-based analysis
title_full_unstemmed	Impact of androgen deprivation therapy on mortality of prostate cancer patients with COVID-19: a propensity score-based analysis
title_sort	impact of androgen deprivation therapy on mortality of prostate cancer patients with covid-19: a propensity score-based analysis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/48f4d7b0b31341858bb6a0c56b2d68d3
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Impact of androgen deprivation therapy on mortality of prostate cancer patients with COVID-19: a propensity score-based analysis

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