ANDROGEN deprivation therapy (ADT) may result in an increased risk of developing nonalcoholic fatty liver disease (NAFLD) and other forms of liver disease for prostate cancer patients, suggest the results of a new study. These results shed light on a clinically important consideration for clinicians when selecting this common form of hormone therapy.
The observational study examined 82,938 men aged ≥66 years who had been diagnosed with localised prostate cancer, 37.5% of who had undergone ADT. These patients were identified via the Surveillance, Epidemiology and End Results (SEER)-Medicare database, using records from 1992–2009. Exclusion criteria included pre-existing NAFLD, other liver diseases, diabetes, and metabolic syndrome.
The results of this analysis showed that those patients that had received ADT had a 54% greater risk of being diagnosed with NAFLD. Other liver diseases also saw a significant increase in incidence in this cohort; diagnoses of cirrhosis, liver necrosis, and any liver disease increased by 35%, 41%, and 47% respectively. Ultimately, there was a correlation between the number of ADT doses and the incidence of NAFLD and other liver diseases.
Whilst the study was limited by its observational design, researchers are confident that this data puts them one step closer to understanding the metabolic impact of ADT. “[This] is an important observation because it highlights a clinically important metabolic perturbation of ADT which is probably unfamiliar to most urologists”, explained Dr Jehonathan Pinthus, McMaster University, Toronto, Canada in an editorial accompanying the study.