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Infect Agent Cancer . Impact of androgen deprivation therapy on mortality of prostate cancer patients with COVID-19: a propensity score-based analy

tetano

Editor, Senior Moderator
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


Mateus Bringel Oliveira Duarte[SUP] 1 2 [/SUP], Frederico Leal[SUP] 1 [/SUP], Juliana Luz Passos Argenton[SUP] 3 [/SUP], José Barreto Campello Carvalheira[SUP] 4 [/SUP]



Affiliations

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.

Keywords: Androgen antagonists; Androgen receptor antagonists; Antineoplastic agents; COVID-19.
 
I think it's the anti-androgen drugs that show benefit, not the Lupron type treatments.

Goren, A., Wambier, C. G., Herrera, S., McCoy, J., Vaño-Galván, S., Gioia, F., Comeche, B., Ron, R., Serrano-Villar, S., Ramos, P. M., Cadegiani, F. A., Kovacevic, M., Tosti, A., Shapiro, J., & Sinclair, R. (2021). Anti-androgens may protect against severe COVID-19 outcomes: results from a prospective cohort study of 77 hospitalized men. Journal of the European Academy of Dermatology and Venereology, 35(1), e13-e15. https://doi.org/10.1111/jdv.16953
 
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