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0 0.5 1 1.5 2+ Mortality 33% Improvement Relative Risk Progression -8% Case -68% c19early.org/aa Jiménez-Alcaide et al. Antiandrogens for COVID-19 Prophylaxis Is prophylaxis with antiandrogens beneficial for COVID-19? Retrospective 1,349 patients in Spain Lower mortality (p=0.41) and more cases (p=0.15), not stat. sig. Jiménez-Alcaide et al., The Prostate, doi:10.1002/pros.24232 Favors various Favors control
Influence of androgen deprivation therapy on the severity of COVID-19 in prostate cancer patients
Jiménez-Alcaide et al., The Prostate, doi:10.1002/pros.24232
Jiménez-Alcaide et al., Influence of androgen deprivation therapy on the severity of COVID-19 in prostate cancer patients, The Prostate, doi:10.1002/pros.24232
Sep 2021   Source   PDF  
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Retrospective 1,349 prostate cancer patients in Spain, 156 on ADT, showing no significant differences in COVID-19 outcomes with treatment.
Although the 33% lower mortality is not statistically significant, it is consistent with the significant 38% lower mortality [21‑51%] from meta analysis of the 32 mortality results to date.
risk of death, 33.0% lower, RR 0.67, p = 0.41, treatment 3 of 11 (27.3%), control 17 of 50 (34.0%), adjusted per study, multivariable.
risk of progression, 8.0% higher, RR 1.08, p = 0.77, treatment 11, control 50, adjusted per study, multivariable.
risk of case, 68.2% higher, RR 1.68, p = 0.15, treatment 11 of 156 (7.1%), control 50 of 1,193 (4.2%), excluded in exclusion analyses: excessive unadjusted differences between groups.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Jiménez-Alcaide et al., 13 Sep 2021, retrospective, Spain, peer-reviewed, 9 authors.
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Abstract: Received: 25 March 2021 | Accepted: 30 August 2021 DOI: 10.1002/pros.24232 ORIGINAL ARTICLE Influence of androgen deprivation therapy on the severity of COVID‐19 in prostate cancer patients Estíbaliz Jiménez‐Alcaide MD1 | Clara García‐Fuentes MD1 | Virginia Hernández MD, PhD1 | Enrique De la Peña MD, PhD1 | Elia Pérez‐Fernández MSc2 | Alejandro Castro MD1 | Begoña Caballero‐Perea MD3 | Ana Guijarro MD1 | Carlos Llorente MD, PhD1 1 Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain Abstract Background: The TMPRSS2 protein has been involved in severe acute respiratory 2 Research Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain 3 Department of Radiation Oncology, Hospital Universitario de Fuenlabrada, Madrid, Spain Correspondence Estíbaliz Jiménez‐Alcaide, MD, Department of Urology, Hospital Universitario Fundación Alcorcón, Avda. Budapest 1, 28922 Alcorcón, Madrid, Spain. Email: estibaliz.jimenez@salud.madrid.org and estibalizjimenez85@gmail.com syndrome caused by coronavirus 2 (SARS‐CoV‐2). The production is regulated by the androgen receptor (AR). It is speculated that androgen deprivation therapy (ADT) may protect patients affected by prostate cancer (PC) from SARS‐CoV‐2 infection. Methods: This is a retrospective study of patients treated for COVID‐19 in our institution who had a previous diagnosis of PC. We analyzed the influence of exposure of ADT on the presence of severe course of COVID‐19. Results: A total of 2280 patients were treated in our center for COVID‐19 with a worse course of disease in males (higher rates of hospitalization, intense care unit [ICU] admission, and death). Out of 1349 subjects registered in our PC database, 156 were on ADT and 1193 were not. Out of those, 61 (4.52%) PC patients suffered from COVID‐19, 11 (18.0%) belonged to the ADT group, and 50 (82.0%) to the non‐ ADT group. Regarding the influence of ADT on the course of the disease, statistically significant differences were found neither in the death rate (27.3% vs. 34%; p = 0.481), nor in the presence of severe COVID‐19: need for intubation or ICU admission (0% vs. 6.3%; p = 0.561) and need for corticoid treatment, interferon beta, or tocilizumab (60% vs. 34.7%; p = 0.128). Multivariate analysis adjusted for clinically relevant comorbidities did not find that ADT was a protective factor for worse clinical evolution (risk ratio [RR] 1.08; 95% confidence interval [CI], 0.64–1.83; p = 0.77) or death (RR, 0.67; 95% CI, 0.26–1.74; p = 0.41). Conclusions: Our study confirms that COVID‐19 is more severe in men. However, the use of ADT in patients with PC was not shown to prevent the risk of severe COVID‐19. KEYWORDS androgen deprivation therapy, COVID‐19, prostatic neoplasms, SARS‐CoV‐2 The Prostate. 2021;81:1349–1354. wileyonlinelibrary.com/journal/pros © 2021 Wiley Periodicals LLC | 1349 1350 1 | JIMÉNEZ‐ALCAIDE ET AL. | INTRODUCTION First of all, demographic characteristics of both groups of patients were analyzed including age and comorbidity measured according to the In late 2019, a new human coronavirus (SARS‐CoV‐2) causing severe Charlson Index, as well as data related to PC: prostate‐specific antigen acute respiratory syndrome (SARS)1–3 was isolated for the first time in (PSA), tumor‐node‐metastases (TNM) stage, Gleason grading system, and Wuhan, China. SARS‐CoV‐2 causes a broad spectrum of diseases that are the primary treatment regime received at diagnosis (radical..
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