Do GnRH Agonists for Prostate Cancer Increase Risks for Dementia and Parkinson’s Disease?
Posted: Wednesday, February 24, 2021
Previous studies have reported conflicting results on the relationship between androgen-deprivation therapy and the development of dementia and Parkinson’s disease. According to a report published in PLOS One, it remains unclear whether the use of a gonadotropin-releasing hormone (GnRH) agonist affects the risk of these neurologic disorders among patients with prostate cancer. Jin Seon Cho, MD, PhD, of Hallym University College of Medicine, Anyang, Korea, and colleagues suggest that further long-term studies are necessary for clarification and that the existing evidence is not adequate to affect current clinical practice.
Using data from the National Health Insurance Service, the researchers conducted a nationwide population cohort study of patients with newly diagnosed prostate cancer who used a GnRH agonist (n = 3,201) and those who did not (n = 4,123) to evaluate the development of dementia and Parkinson’s disease. The study team also analyzed a hospital cohort of GnRH agonist users (n = 205) and nonusers (n = 479) to validate the data.
Univariable analysis of both nationwide and hospital validation cohorts indicated that using a GnRH agonist was associated with dementia (hazard ratio = 1.696 and 1.352, respectively). Yet, in the nationwide cohort, both traditional and propensity score–matched multivariable analysis resulted in no such association between androgen-deprivation therapy and dementia. When the researchers focused on the hospital validation cohort, androgen-deprivation therapy was associated with dementia alone in an unmatched analysis (hazard ratio = 1.203) but lost its significance when the study team conducted propensity score–matched analysis. No association was found between androgen-deprivation therapy and Parkinson’s disease in either the nationwide or validation cohort.
Disclosure: The study authors reported no conflicts of interest.