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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality -16% Improvement Relative Risk Ventilation 19% Severe case -3% Hospitalization 4% Antiandrogens for COVID-19  Shah et al.  Prophylaxis Is prophylaxis with antiandrogens beneficial for COVID-19? Retrospective 465 patients in the USA (March - May 2020) Higher mortality with antiandrogens (not stat. sig., p=0.59) Shah et al., JNCI Cancer Spectrum, May 2022 Favors antiandrogen Favors control

The Impact of Androgen Deprivation Therapy on COVID-19 Illness in Men With Prostate Cancer

Shah et al., JNCI Cancer Spectrum, doi:10.1093/jncics/pkac035
May 2022  
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5th treatment shown to reduce risk in August 2020
*, now known with p = 0.000000043 from 50 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
Retrospective 465 prostate cancer patients, showing no significant difference in COVID-19 outcomes with ADT.
risk of death, 16.0% higher, HR 1.16, p = 0.59, treatment 148, control 317.
risk of mechanical ventilation, 19.0% lower, HR 0.81, p = 0.73, treatment 148, control 317.
risk of severe case, 3.0% higher, HR 1.03, p = 0.91, treatment 148, control 317.
risk of hospitalization, 4.0% lower, HR 0.96, p = 0.90, treatment 148, control 317.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Shah et al., 12 May 2022, retrospective, USA, peer-reviewed, median age 71.0, 22 authors, study period 1 March, 2020 - 31 May, 2020. Contact:
This PaperAntiandrogensAll
The Impact of Androgen Deprivation Therapy on COVID-19 Illness in Men With Prostate Cancer
MD Neil J Shah, MD Vaibhav G Patel, DrPD Xiaobo Zhong, MD Luis Pina, MD Jessica E Hawley, MD Emily Lin, MD Benjamin A Gartrell, MD Victor Adorno Febles, MD David R Wise, MD Qian Qin, BA George Mellgard, PhD Himanshu Joshi, MD Jones T Nauseef, MD David A Green, MD Panagiotis J Vlachostergios, MD Daniel H Kwon, MD Franklin Huang, MD Bobby Liaw, MD Scott Tagawa, MD Philip Kantoff, MD Michael J Morris, MD William K Oh
JNCI Cancer Spectrum, doi:10.1093/jncics/pkac035
Background: TMPRSS2, a cell surface protease regulated by androgens and commonly upregulated in prostate cancer (PCa), is a necessary component for SARS-CoV-2 viral entry into respiratory epithelial cells. Previous reports suggested a lower risk of SARS-CoV-2 among PCa patients on androgen deprivation therapy (ADT). However, the impact of ADT on severe COVID-19 illness is poorly understood. Methods: We performed a multicenter study across 7 US medical centers and evaluated patients with PCa and SARS-CoV-2 detected by polymerase-chain-reaction between March 1, 2020, and May 31, 2020. PCa patients were considered on ADT if they had received appropriate ADT treatment within 6 months of COVID-19 diagnosis. We used multivariable logistic and Cox proportional-hazard regression models for analysis. All statistical tests were 2-sided. Results: We identified 465 PCa patients (median age ¼ 71 years) with a median follow-up of 60 days. Age, body mass index, cardiovascular comorbidity, and PCa clinical disease state adjusted overall survival (hazard ratio [HR] ¼ 1.16, 95% confidence interval [CI] ¼ 0.68 to 1.98, P ¼ .59), hospitalization status (HR ¼ 0.96, 95% CI ¼ 0.52 to 1.77, P ¼ .90), supplemental oxygenation (HR 1.14, 95% CI ¼ 0.66 to 1.99, P ¼ .64), and use of mechanical ventilation (HR ¼ 0.81, 95% CI ¼ 0.25 to 2.66, P ¼ .73) were similar between ADT and non-ADT cohorts. Similarly, the addition of androgen receptor-directed therapy within 30 days of COVID-19 diagnosis to ADT vs ADT alone did not statistically significantly affect overall survival (androgen receptor-directed therapy: HR ¼ 1.27, 95% CI ¼ 0.69 to 2.32, P ¼ .44). Conclusions: In this retrospective cohort of PCa patients, the use of ADT was not demonstrated to influence severe COVID-19 outcomes, as defined by hospitalization, supplemental oxygen use, or death. Age 70 years and older was statistically significantly associated with a higher risk of developing severe COVID-19 disease.
Notes Role of the funder: The design, interpretation, and analysis of this study, the writing of the manuscript, and decision to submit the manuscript for publication rest solely with the authors.
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