Introduction

Novel non-steroidal anti-androgens (NSAA) are increasingly part of the management of prostate cancer. We aimed to quantify and compare the neurologic side effects of NSAA agents.

Materials and methods

Phase III randomized controlled trials evaluating NSAAs in the treatment of prostate cancer were selected by two reviewers independently in MEDLINE. A random-effects model and the Mantel-Haenszel method were used. The Odds Ratio (OR) and its 95 % confidence interval were computed. The primary endpoints were the rates of neurologic adverse events.

Results

Eight phase III trials evaluating novel NSAAs (vs. non-NSAAs) were included. Fatigue (OR:1.66 [1.32–2.08]), falls (OR:1.76 [1.25–2.49]), headache (OR:1.74 [1.42–2.14]), and dizziness (OR:1.70 [1.33–2.19]) were found to be significantly associated with NSAA use.

Conclusions

NSAAs are associated with an increase in various neurologic adverse events. When NSAAs are prescribed, neurologic adverse event prevention and management strategies should be discussed and implemented.

中文翻译：

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新型非甾体类抗雄激素对前列腺癌的神经毒性：系统评价和荟萃分析

介绍

新型非甾体类抗雄激素 (NSAA) 越来越多地成为前列腺癌治疗的一部分。我们旨在量化和比较 NSAA 药物的神经系统副作用。

材料和方法

评价 NSAA 治疗前列腺癌的 III 期随机对照试验由 MEDLINE 中的两名评审员独立选择。使用了随机效应模型和 Mantel-Haenszel 方法。计算优势比 (OR) 及其 95% 置信区间。主要终点是神经系统不良事件的发生率。

结果

包括八项评估新型 NSAA（与非 NSAA）的 III 期试验。发现疲劳（OR：1.66 [1.32-2.08]）、跌倒（OR：1.76 [1.25-2.49]）、头痛（OR：1.74 [1.42-2.14]）和头晕（OR：1.70 [1.33-2.19]）与 NSAA 的使用显着相关。

结论

NSAA 与各种神经系统不良事件的增加有关。当规定 NSAA 时，应讨论和实施神经系统不良事件的预防和管理策略。