Those were the results of a new study led by researchers from the Saint Louis University School of Medicine.
“With new therapies for metastatic prostate cancer, patients are living longer, increasing the need for better understanding of the impact of comorbid disease,” study authors wrote in Anticancer Research. “Prescription medications may risk-stratify patients independent of established methods, such as the Charlson Comorbidity Index (CCI) and guide treatment selection.”
The study team conducted a nationwide retrospective study of U.S. military veterans to evaluate the association between the number and class of prescription medications and overall survival (OS) with age, race, BMI, prostate specific antigen (PSA), and Charlson comorbidities as covariates. The focus was on patients treated for de novo mHSPC from 2010 to 2021.
The results indicated that, among 8,434 patients, a median of nine medications and five medication classes were filled in the year prior to initial treatment with abiraterone or enzalutamide for mHSPC. The researchers reported that those on one to four medications had an average survival of 38 months compared with five to nine medicines (33 months), 10–14 medicines (27 months), and 15+ medicines (22 months; P <.001).
“After adjusting for age, race, body mass index (BMI), PSA, CCI, and year of diagnosis, both the number of medications and medication classes were associated with increased mortality,” the authors advised.
The study pointed out the adjusted hazard ratio (aHR; 95% CI, 1.03 [1.02-1.03]) for the number of medications and for medication classes (1.05 [1.04-1.07]). Medications within ATC B (blood/blood forming organs), ATC C (cardiovascular), and ATC N (nervous system) were associated with worse overall survival with aHRs of 1.14 (1.07, 1.21), 1.14 (1.06, 1.22), and 1.12 (1.06, 1.19), respectively, according to the report.
“The number and class of medications were independently associated with overall survival in patients undergoing treatment for mHSPC,” the researchers wrote. “With new therapies for advanced prostate cancer, patients are living longer, highlighting the need for a better understanding of the impact of comorbid diseases. Simple methods to assess disease burden and prognosticate survival have the potential to guide treatment decisions.”
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