{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T02:02:38Z","timestamp":1784512958318,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:00:00Z","timestamp":1781913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:00:00Z","timestamp":1781913600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["3UL1TR002378\u201002S2"],"award-info":[{"award-number":["3UL1TR002378\u201002S2"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Men with castration\u2010resistant prostate cancer (CRPC) who have a pre\u2010existing history of cardiovascular disease (CVD) or other comorbidities are often excluded from clinical trials involving oral androgen receptor pathway inhibitors (ARPi). In this study, we compared all\u2010cause and prostate cancer\u2010specific mortality among CRPC patients, with and without a pre\u2010existing history of CVD, receiving ARPi compared to chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Men with CRPC were identified using the Surveillance, Epidemiology, and End Results\u2010Medicare Linked Database from 2004 to 2015. Patients were grouped into two analytical cohorts by drug use. Inverse probability treatment weights (IPTW)\u2010adjusted Cox models and Fine\u2010Gray subdistribution hazards models were used to evaluate associations between ARPi and chemotherapy, and between ENZ and AA for all\u2010cause mortality and cancer\u2010specific mortality separately.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study cohort included 1438 men with CRPC. Nearly 54.4% of patients had a pre\u2010existing history of CVD. Patients with a pre\u2010existing history of CVD had a higher incidence of all\u2010cause and prostate cancer\u2010specific mortality compared to patients without a history of CVD (all\u2010cause mortality: 69.7% vs. 59.3%, prostate cancer\u2010specific mortality: 56.0% vs. 49.5%, respectively). In the pre\u2010existing history of CVD cohort, the IPTW\u2010adjusted Cox model showed a significantly lower all\u2010cause mortality in patients who received APRi, enzalutamide, and abiraterone, versus chemotherapy (IPTW\u2010adjusted hazard ratio [AHR], 0.56; 95% Confidence Interval [CI], 0.48\u20130.64;\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value\u2009&lt;\u20090.001). Further, the IPTW\u2010adjusted competing risk model showed significantly lower prostate cancer\u2010specific mortality in patients who received ARPi compared with those who received chemotherapy (IPTW\u2010AHR, 0.48; 95% CI, 0.41 to 0.57;\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value\u2009&lt;\u20090.001). In the without pre\u2010existing history of CVD cohort, the adjusted Cox model showed significantly lower all\u2010cause mortality in patients who received APRi than those who received chemotherapy (IPTW\u2010AHR, 0.49; 95% CI, 0.41\u20130.60;\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value\u2009&lt;\u20090.001). Whereas the IPTW\u2010adjusted competing risk model showed significantly lower prostate cancer\u2010specific mortality in patients who received ARPi compared with those who received chemotherapy (IPTW\u2010AHR, 0.52; 95% CI, 0.42\u20130.64;\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value &lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this population\u2010based cohort of older men with castration\u2010resistant prostate cancer, treatment with oral androgen receptor pathway inhibitors was associated with lower estimated risks of all\u2010cause and prostate cancer\u2013specific mortality compared with chemotherapy in patients with and without pre\u2010existing CVD. These findings add real\u2010world comparative effectiveness evidence for patient populations not well represented in randomized clinical trials; however, given the observational design and limitations of administrative data, residual confounding and unmeasured clinical differences may have influenced the results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70405","type":"journal-article","created":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T07:36:59Z","timestamp":1781941019000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mortality in Castration Resistant Prostate Cancer Patients With and Without Pre\u2010Existing Cardiovascular Disease Receiving Oral Androgen Receptor Pathway Inhibitors"],"prefix":"10.1002","volume":"35","author":[{"given":"Ibrahim M.","family":"Asiri","sequence":"first","affiliation":[{"name":"Saudi Food &amp; Drug Authority  Riyadh Saudi Arabia"},{"name":"Department of Quantitative Health Science Mayo Clinic College of Medicine and Sciences  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald C.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Kansas, School of Medicine  Kansas City Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viraj","family":"Master","sequence":"additional","affiliation":[{"name":"Department of Urology Emory University, School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lanyu","family":"Mi","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Science Mayo Clinic College of Medicine and Sciences  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"James","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Mayo Clinic College of Medicine and Sciences  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandra","family":"Moore","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology Mayo Clinic College of Medicine and Sciences  Phoenix Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan H.","family":"Bryce","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology &amp; Therapeutics Research City of Hope  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon C.","family":"Tilburt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Mayo Clinic College of Medicine and Sciences  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irbaz B.","family":"Riaz","sequence":"additional","affiliation":[{"name":"Department of Medicine Mayo Clinic College of Medicine and Sciences  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Arsalan Ahmed","family":"Naqvi","sequence":"additional","affiliation":[{"name":"Department of Medicine Mayo Clinic College of Medicine and Sciences  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umar","family":"Afzal","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Science Mayo Clinic College of Medicine and Sciences  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven R. H.","family":"Beach","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Georgia, Franklin College of Arts and Sciences  Athens Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1842-312X","authenticated-orcid":false,"given":"Ewan K.","family":"Cobran","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Science Mayo Clinic College of Medicine and Sciences  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,20]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2016.16233"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-018-0774-1"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2015-0166"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2016.07.032"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)71205-7"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2019.07.031"},{"issue":"8","key":"e_1_2_12_8_1","first-page":"IV\u20103\u201018","article-title":"Overview of the SEER\u2010Medicare Data: Content, Research Applications, and Generalizability to the United States Elderly Population","volume":"40","author":"Warren J. L.","year":"2002","journal-title":"Medical Care"},{"issue":"12","key":"e_1_2_12_9_1","first-page":"1117","article-title":"The Surveillance, Epidemiology, and End Results Program: A National Resource","volume":"8","author":"Hankey B. F.","year":"1999","journal-title":"Cancer Epidemiology Biomarkers & Prevention"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3334"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40471-015-0053-5"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2015.30"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwg231"},{"key":"e_1_2_12_14_1","volume-title":"NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines)","author":"Network NCC","year":"2018"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2014.10.104"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2006.00585.x"},{"issue":"4","key":"e_1_2_12_17_1","first-page":"57","article-title":"Disabled Medicare Beneficiaries by Dual Eligible Status: California, 1996\u20132001","volume":"28","author":"O'Leary J. E.","year":"2007","journal-title":"Health Care Financing Review"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2009.01051.x"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/70.1.41"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12197"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"issue":"4","key":"e_1_2_12_22_1","first-page":"185","article-title":"Treatment Sequences and Pharmacy Costs of 2 New Therapies for Metastatic Castration\u2010Resistant Prostate Cancer","volume":"8","author":"Ellis L. A.","year":"2015","journal-title":"American Health and Drug Benefits"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70379-0"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1209096"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwaa190"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-021-00318-3"}],"container-title":["Pharmacoepidemiology and Drug Safety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.70405","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pds.70405","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.70405","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T01:41:37Z","timestamp":1784511697000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pds.70405"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,20]]},"references-count":25,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/pds.70405"],"URL":"https:\/\/doi.org\/10.1002\/pds.70405","archive":["Portico"],"relation":{},"ISSN":["1053-8569","1099-1557"],"issn-type":[{"value":"1053-8569","type":"print"},{"value":"1099-1557","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,20]]},"assertion":[{"value":"2024-11-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70405"}}