medRxiv : the preprint server for health sciences · 2026
GLP-1 Receptor Agonists and Cardiovascular Events During Androgen Receptor Pathway Inhibitor Therapy.
СтатьяПрепринтНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Atkins Katelyn M, Chakravarty Nikhil, Oorloff Maria, Grigsby Giana, Khan Irfan, Kamrava Mitchell, Nikolova Andriana, Karlstaedt Anja, Ramin Cody, Ballas Leslie K
Аннотация
BACKGROUND: Androgen receptor pathway inhibitors (ARPIs) have transformed the treatment of high risk and metastatic prostate cancer, though are associated with increased cardiovascular risk. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been shown to reduce cardiovascular events in non-cancer populations, but their role in patients receiving ARPIs is unclear.
METHODS: Retrospective analysis of 120 men with PC treated with ARPIs between 2015-2025 with any GLP-1 RA exposure. The time of GLP-1 RA use was categorized relative to ARPI initiation (pre- vs post-ARPI). Cumulative incidences for major adverse cardiac events (MACE) any grade 2 or greater cardiac common terminology criteria for adverse events (CTCAE) were estimated. Fine-Gray regressions were performed (non-cardiac death as a competing risk).
RESULTS: The median follow-up was 2.3 years (interquartile range [IQR] 1.3-3.7). The median age was 72 years (IQR 66-78). Atherosclerotic cardiovascular disease (ASCVD) was present in 45.0% (n=54). Overall, 55.0% (n=66) initiated GLP-1 RA therapy prior to ARPI and 45.0% (n=54) after ARPI initiation, with a median duration of GLP-1 RA use of 4.0 years (IQR, 2.3-7.0) and 1.3 years (IQR, 0.6-2.1), respectively. Four patients experienced MACE, including three coronary revascularizations and one ischemic stroke. 25 patients experienced at least one grade 2 or greater cardiac event, most commonly arrhythmia (n=20) and thromboembolic disease (n=11). The 2-year cumulative incidence of MACE and grade >2 cardiac events was 1.7% and 16.1%, respectively. Adjusting for pre-existing cardiovascular risk, GLP-1 RA duration, and pre-ARPI androgen deprivation therapy use, GLP-1RA use prior to ARPI initiation (vs. after ARPI start) was associated with reduced risk of grade >2 cardiac events (subdistribution hazard ratio 0.26, 95% CI 0.08-0.91; p=0.036).
CONCLUSION: GLP-1 RA use prior to ARPI initiation was associated with reduced risk of cardiac events, suggesting that earlier metabolic optimization may influence cardiovascular outcomes. These hypothesis-generating findings support investigation of early GLP-1 RA initiation as a potential cardiovascular risk mitigation strategy during ARPI therapy.
METHODS: Retrospective analysis of 120 men with PC treated with ARPIs between 2015-2025 with any GLP-1 RA exposure. The time of GLP-1 RA use was categorized relative to ARPI initiation (pre- vs post-ARPI). Cumulative incidences for major adverse cardiac events (MACE) any grade 2 or greater cardiac common terminology criteria for adverse events (CTCAE) were estimated. Fine-Gray regressions were performed (non-cardiac death as a competing risk).
RESULTS: The median follow-up was 2.3 years (interquartile range [IQR] 1.3-3.7). The median age was 72 years (IQR 66-78). Atherosclerotic cardiovascular disease (ASCVD) was present in 45.0% (n=54). Overall, 55.0% (n=66) initiated GLP-1 RA therapy prior to ARPI and 45.0% (n=54) after ARPI initiation, with a median duration of GLP-1 RA use of 4.0 years (IQR, 2.3-7.0) and 1.3 years (IQR, 0.6-2.1), respectively. Four patients experienced MACE, including three coronary revascularizations and one ischemic stroke. 25 patients experienced at least one grade 2 or greater cardiac event, most commonly arrhythmia (n=20) and thromboembolic disease (n=11). The 2-year cumulative incidence of MACE and grade >2 cardiac events was 1.7% and 16.1%, respectively. Adjusting for pre-existing cardiovascular risk, GLP-1 RA duration, and pre-ARPI androgen deprivation therapy use, GLP-1RA use prior to ARPI initiation (vs. after ARPI start) was associated with reduced risk of grade >2 cardiac events (subdistribution hazard ratio 0.26, 95% CI 0.08-0.91; p=0.036).
CONCLUSION: GLP-1 RA use prior to ARPI initiation was associated with reduced risk of cardiac events, suggesting that earlier metabolic optimization may influence cardiovascular outcomes. These hypothesis-generating findings support investigation of early GLP-1 RA initiation as a potential cardiovascular risk mitigation strategy during ARPI therapy.