{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T21:45:00Z","timestamp":1792014300879,"version":"4.4.0"},"reference-count":32,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,9,4]],"date-time":"2018-09-04T00:00:00Z","timestamp":1536019200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004917","name":"Cancer Prevention and Research Institute of Texas","doi-asserted-by":"publisher","award":["grant no. RP170668"],"award-info":[{"award-number":["grant no. RP170668"]}],"id":[{"id":"10.13039\/100004917","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec>\n                    <jats:title>Study Objective<\/jats:title>\n                    <jats:p>To examine the risks and compare the occurrences of major long\u2010term side effects (sexual dysfunction, bone fractures, diabetes, cardiovascular morbidity, acute myocardial infarction [MI], and dementia) in patients with prostate cancer who received androgen\u2010deprivation therapy (ADT) with those who did not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Propensity score\u2013matched retrospective cohort study using Medicare claims data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Source<\/jats:title>\n                    <jats:p>National Cancer Institute's Surveillance, Epidemiology, and End Results Program\u2013Medicare linked database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>A total of 201,797 patients 66 years or older who were diagnosed with any stage of prostate cancer between 1992 and 2009; of these, 94,528 patients received ADT; 107,269 patients did not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>We identified receipt of ADT and number of claims for ADT, and ascertained the long\u2010term treatment\u2010related side effects that occurred during 19 years of follow\u2010up, from 1992\u20132010, from Medicare claims data. Cox proportional hazards models were used to estimate the incidences and hazard ratios (HRs) of newly developed side effects. Among all potential long\u2010term side effects, the risk of bone fractures was highest (HR 1.39, 95% confidence interval [CI] 1.35\u20131.43), followed by diabetes (HR 1.21, 95% CI 1.18\u20131.24), dementia (HR 1.16, 95% CI 1.13\u20131.20), coronary heart disease (HR 1.12, 95% CI 1.09\u20131.14), and acute MI (HR 1.11, 95% CI 1.08\u20131.15) in those who received ADT compared with those who did not. The HRs for bone fractures and diabetes increased steadily as the number of ADT doses increased, indicating a linear trend in the dose\u2010response relationship. Compared with patients who received active surveillance, ADT was associated with a 12% increased risk of sexual dysfunction (HR 1.12, 95% CI 1.05\u20131.20). The HR for sexual dysfunction increased to 1.68 (95% CI 1.59\u20131.77) when ADT was combined with radiation therapy and to 3.54 (95% CI 3.26\u20133.85) when ADT was combined with radiation and surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The results of this study demonstrated that in men with prostate cancer, receipt of ADT was associated with higher risks of bone fractures, diabetes, dementia, coronary heart disease, acute MI, and sexual dysfunction than in those who did not receive ADT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/phar.2168","type":"journal-article","created":{"date-parts":[[2018,8,7]],"date-time":"2018-08-07T07:11:34Z","timestamp":1533625894000},"page":"999-1009","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":77,"title":["Risks of Major Long\u2010Term Side Effects Associated with Androgen\u2010Deprivation Therapy in Men with Prostate Cancer"],"prefix":"10.1002","volume":"38","author":[{"given":"Chi","family":"Nguyen","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Human Genetics, and Environmental Science School of Public Health University of Texas Health Science Center at Houston Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Lairson","sequence":"additional","affiliation":[{"name":"Department of Management Policy and Community Health School of Public Health University of Texas Health Science Center at Houston  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Swartz","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science School of Public Health University of Texas Health Science Center at Houston Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0119-5252","authenticated-orcid":false,"given":"Xianglin L.","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Human Genetics, and Environmental Science School of Public Health University of Texas Health Science Center at Houston Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,4]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (NCCN Guidelines) Prostate Cancer Version 3.2016. 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