Dr. Cone on Evaluating the Relative Cardiac Risk of GnRH Agonists Versus Antagonists in Prostate Cancer

Eugene B. Cone, MD, a urologic oncology fellow at Brigham and Women’s Hospital and Massachusetts General Hospital, discusses the methods that were used to evaluate the relative cardiac risk of gonadotropin-releasing hormone (GnRH) agonists versus antagonists in patients with prostate cancer.

Investigators pooled information from VigiBase, which is a database from the World Health Organization that accumulates reports from over 130 countries. In order to perform a propensity-based analysis, investigators compiled the number of patients who received these drugs and reported the number of adverse events (AEs) associated with their use; that number served as the denominator. Then, investigators examined the number of patients who took these drugs and experienced cardiac AEs.

To determine what the expected count should be, investigators took everyone who received any other drug in the database, from aspirin to chemotherapy, and experienced any AE. Then, investigators looked at the number of patients who took any other drug and had a cardiac AE to see what the expected event rate would be. Finally, investigators compared the two rates and determined whether there was a signal or not with GnRH agonists and antagonists.