Infect Agent Cancer. 2021 Nov 25;16(1):66. doi: 10.1186/s13027-021-00406-y.
Impact of androgen deprivation therapy on mortality of prostate cancer patients with COVID-19: a propensity score-based analysis.
Infectious agents and cancer
Mateus Bringel Oliveira Duarte, Frederico Leal, Juliana Luz Passos Argenton, José Barreto Campello Carvalheira
Affiliations
Affiliations
- Division of Oncology, Department of Anesthesiology, Oncology and Radiology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil.
- Uberlândia Cancer Hospital, Federal University of Uberlândia, UFU, Uberlândia, MG, Brazil.
- Fundação de Desenvolvimento da Universidade Estadual de Campinas (FUNCAMP), Campinas, SP, Brazil.
- Division of Oncology, Department of Anesthesiology, Oncology and Radiology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil. [email protected].
PMID: 34823563
PMCID: PMC8614632 DOI: 10.1186/s13027-021-00406-y
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.
© 2021. The Author(s).
Keywords: Androgen antagonists; Androgen receptor antagonists; Antineoplastic agents; COVID-19
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