Medical Oncology

, 34:166 | Cite as

Low dose versus standard dose of corticosteroids in the management of adverse events of special interest from abiraterone acetate: data from a literature-based meta-analysis

  • Giandomenico Roviello
  • Silvia Paola Corona
  • Daniele Generali
Short Communication
  • 465 Downloads

Abstract

Abiraterone acetate is a CYP-17 inhibitor approved for the treatment of prostate cancer. Abiraterone acetate (AA) therapy is associated with toxicities, including hypokalemia, hypertension, liver function test abnormalities and cardiac events. These adverse events are traditionally managed with a standard dose of corticosteroids. However, preliminary data are available on the use of a lower dose of corticosteroids. The aim of this report is to perform a pooled analysis evaluating the risk ratio (RR) of AA-related adverse events of special interest associated with low or standard dose of corticosteroids. A total of 5374 cases from 4 randomized clinical trials were included. Subgroup analysis according to corticosteroids dosage revealed a higher RR of adverse events associated with a dose of 5 mg, compared to 10 mg. In particular, there was a statistically significant higher RR of hypokalemia and ALT/AST increase, and only a modest risk increase for cardiac disorders and hypertension. In conclusion, given the limitations of a literature-based study, in comparison with a meta-analysis based on individual patients’ data, our study identified a relatively small increase in RR for hypertension and cardiac disorders and a bigger increase of RR for hypokalemia and ALT/AST toxicity when 5 mg, rather than 10 mg of corticosteroids were administered to manage adverse events of special interest from AA. Further studies with specified end-points are awaited to confirm these results.

Keywords

Abiraterone Corticosteroids Safety Mineralocorticoid events 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

12032_2017_1028_MOESM1_ESM.docx (36 kb)
Supplementary material 1 (DOCX 36 kb)

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Medical Oncology Unit, Department of OncologySan Donato HospitalArezzoItaly
  2. 2.Department of Medical, Surgery and Health SciencesUniversity of TriesteTriesteItaly
  3. 3.Radiation Oncology DepartmentPeter MacCallum Cancer CentreEast BentleighAustralia
  4. 4.Breast Cancer UnitASST CremonaCremonaItaly

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