{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:20:25Z","timestamp":1786980025265,"version":"build-2736575974"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Urol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study investigated the risk of major cardiovascular (CV) events in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with abiraterone acetate (AA) versus enzalutamide (ENZA); assessed treatments for prostate cancer (PC), focusing on corticosteroid-containing regimens; and examined comorbidities recorded in primary and secondary care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a post hoc analysis of the retrospective, observational EVADE study in patients who received AA or ENZA for mCRPC. Patient characteristics at treatment initiation were described, focusing on characteristics affecting the risk of CV events, together with PC treatments in the entire PC pathway. Major CV event risk was assessed with Cox regression after adjustment with inverse probability of treatment weighting (IPTW).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 1,382 patients were included (AA: 556; ENZA: 826). After IPTW adjustment, risk of a major CV event was 65.0% higher in the AA versus the ENZA group (hazard ratio: 1.65; 95% confidence interval: 1.27, 2.14;\n                      <jats:italic>P\u2009=<\/jats:italic>\n                      \u20090.0001). Across the entire patient pathway, the average time on corticosteroid-containing PC regimens was 298 days versus 72 days for the AA versus ENZA group. While type 2 diabetes was less frequently reported in secondary versus primary care (59.8% vs. 94.9%), CV comorbidities were more frequently reported (87.1% vs. 84.2%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Major CV event risk was significantly higher in the AA versus ENZA group, and the AA group had numerically greater exposure to corticosteroid-containing PC regimens over the treatment course. There were discrepancies in recording diabetes and CV comorbidities between primary and secondary care in England.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00345-025-05841-9","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T13:49:25Z","timestamp":1754056165000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association between major cardiovascular events and abiraterone acetate compared to enzalutamide in patients with metastatic castration-resistant prostate cancer: a post hoc analysis of the EVADE study"],"prefix":"10.1007","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8525-0310","authenticated-orcid":false,"given":"Amit","family":"Bahl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7086-4703","authenticated-orcid":false,"given":"Andrew","family":"Chilelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3410-1435","authenticated-orcid":false,"given":"Rita","family":"Faria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1510-1675","authenticated-orcid":false,"given":"Nigel","family":"Rozario","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5495-8287","authenticated-orcid":false,"given":"Robert","family":"Snijder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sari","family":"Stark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6467-3931","authenticated-orcid":false,"given":"Axel S.","family":"Merseburger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,1]]},"reference":[{"key":"5841_CR1","unstructured":"Astella Pharma Ltd (2024) Xtandi Summary of Product Characteristics.\u00a0https:\/\/www.medicines.org.uk\/emc\/product\/10318\/smpc#gref. Accessed 21 Nov 2024"},{"key":"5841_CR2","unstructured":"Janssen-Cilag Ltd (2022) Zytiga Summary of Product Characteristics.\u00a0https:\/\/www.medicines.org.uk\/emc\/product\/2381\/smpc#gref. Accessed 21 Nov 2024"},{"key":"5841_CR3","unstructured":"NICE (2016) Abiraterone for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated. Technology appraisal guidance [TA387].\u00a0https:\/\/www.nice.org.uk\/guidance\/ta387\/chapter\/1-Recommendations. Accessed 4 Apr 2023"},{"key":"5841_CR4","unstructured":"NICE (2016) Enzalutamide for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated. Technology appraisal guidance [TA377].\u00a0https:\/\/www.nice.org.uk\/guidance\/ta377\/chapter\/8-Sources-of-evidence-considered-by-the-Committee. Accessed 4 Apr 2023"},{"key":"5841_CR5","unstructured":"NICE (2016) Abiraterone for castration-resistant metastatic prostate cancer previously treated with a docetaxel-containing regimen. Technology appraisal guidance [TA259].\u00a0https:\/\/alpha.nice.org.uk\/guidance\/ta259\/chapter\/About-this-guidance. Accessed 6 Jan 2025"},{"key":"5841_CR6","unstructured":"NICE (2014) Enzalutamide for metastatic hormone\u2013relapsed prostate cancer previously treated with a docetaxel\u2013containing regimen. Technology appraisal guidance [TA316].\u00a0https:\/\/www.nice.org.uk\/Guidance\/TA316. Accessed 6 Jan 2025"},{"key":"5841_CR7","doi-asserted-by":"crossref","unstructured":"Freedland SJ, Gratie D, Touya M, Jayakumar A, Thompson B, Horblyuk R, OIvanova JI (2024) Real-world overall survival of enzalutamide versus abiraterone in metastatic castration-resistant prostate cancer: A targeted literature review. EMUC24\u201316th European multidisciplinary Congress on urological cancers. Lisbon, Portugal","DOI":"10.1016\/S2666-1683(24)01258-8"},{"key":"5841_CR8","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1491314","author":"A Aprikian","year":"2025","unstructured":"Aprikian A, Bahl A, Omlin A, Baciarello G, Chakravarty A, Kondaparthi P, Gourgioti G, McLean T, Serikoff A, Chilelli A (2025) Meta-analysis to evaluate the comparative effectiveness of enzalutamide and abiraterone acetate for first-line treatment of metastatic castration-resistant prostate cancer in real-world settings. Front Oncol. https:\/\/doi.org\/10.3389\/fonc.2025.1491314","journal-title":"Front Oncol"},{"issue":"15","key":"5841_CR9","doi-asserted-by":"publisher","first-page":"3773","DOI":"10.3390\/cancers14153773","volume":"14","author":"YB Shah","year":"2022","unstructured":"Shah YB, Shaver AL, Beiriger J, Mehta S, Nikita N, Kelly WK, Freedland SJ, Lu-Yao G (2022) Outcomes following abiraterone versus enzalutamide for prostate cancer: a scoping review. Cancers (Basel) 14(15):3773","journal-title":"Cancers (Basel)"},{"issue":"1","key":"5841_CR10","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1038\/s41391-020-00275-3","volume":"24","author":"HY Lee","year":"2021","unstructured":"Lee HY, Chen HL, Teoh JY, Chen TC, Hao SY, Tsai HY, Huang WH, Juan YS, Cheng HM, Chang HM (2021) Abiraterone and enzalutamide had different adverse effects on the cardiovascular system: a systematic review with pairwise and network meta-analyses. Prostate Cancer Prostatic Dis 24(1):244\u2013252","journal-title":"Prostate Cancer Prostatic Dis"},{"issue":"3","key":"5841_CR11","doi-asserted-by":"publisher","first-page":"e645","DOI":"10.1016\/j.clgc.2017.12.007","volume":"16","author":"R Iacovelli","year":"2018","unstructured":"Iacovelli R, Ciccarese C, Bria E, Romano M, Fantinel E, Bimbatti D, Muraglia A, Porcaro AB, Siracusano S, Brunelli M, Mazzarotto R, Artibani W, Tortora G (2018) The cardiovascular toxicity of abiraterone and enzalutamide in prostate cancer. Clin Genitourin Cancer 16(3):e645\u2013e53","journal-title":"Clin Genitourin Cancer"},{"issue":"1","key":"5841_CR12","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.clgc.2021.08.009","volume":"20","author":"J Hu","year":"2022","unstructured":"Hu J, Aprikian AG, Vanhuyse M, Dragomir A (2022) Comparative cardiovascular safety of novel hormonal agents in metastatic castration-resistant prostate cancer using real-world data. Clin Genitourin Cancer 20(1):17\u201324","journal-title":"Clin Genitourin Cancer"},{"issue":"7","key":"5841_CR13","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1002\/pros.24510","volume":"83","author":"MM Conover","year":"2023","unstructured":"Conover MM, Weaver J, Fan B, Leitz G, Richarz U, Li Q, Gifkins D (2023) Cardiovascular outcomes among patients with castration-resistant prostate cancer: a comparative safety study using US administrative claims data. Prostate 83(7):729\u2013739","journal-title":"Prostate"},{"issue":"6","key":"5841_CR14","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1002\/ijc.34348","volume":"152","author":"HK Chen","year":"2023","unstructured":"Chen HK, Su PJ, Wang YL, Chang KC, Su YL, Chang PH, Kuan FC, Hsieh CH, Kuo YC, Sheng TW, Chang CF, Yu SM, Huang WK, Lin YC, Tsan DL, Yu KJ, Lin PH, Chen HY, Chang YH, Pang ST, Chuang CK, Lai EC (2023) Long-term use and risk of major adverse cardiac events: comparing enzalutamide and abiraterone in chemotherapy-na\u00efve patients with metastatic castration-resistant prostate cancer. Int J Cancer 152(6):1191\u20131201","journal-title":"Int J Cancer"},{"key":"5841_CR15","doi-asserted-by":"publisher","first-page":"100887","DOI":"10.1016\/j.eclinm.2021.100887","volume":"36","author":"EB Cone","year":"2021","unstructured":"Cone EB, Reese S, Marchese M, Nabi J, McKay RR, Kilbridge KL, Trinh QD (2021) Cardiovascular toxicities associated with abiraterone compared to enzalutamide-A pharmacovigilance study. EClinicalMedicine 36:100887","journal-title":"EClinicalMedicine"},{"issue":"5","key":"5841_CR16","doi-asserted-by":"publisher","first-page":"100261","DOI":"10.1016\/j.esmoop.2021.100261","volume":"6","author":"AA Kulkarni","year":"2021","unstructured":"Kulkarni AA, Rubin N, Tholkes A, Shah S, Ryan CJ, Lutsey PL, Prizment A, Rao A (2021) Risk for stroke and myocardial infarction with abiraterone versus enzalutamide in metastatic prostate cancer patients. ESMO Open 6(5):100261","journal-title":"ESMO Open"},{"issue":"8","key":"5841_CR17","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1093\/jnci\/djac081","volume":"114","author":"LY Lai","year":"2022","unstructured":"Lai LY, Oerline MK, Caram ME, Tsao PA, Kaufman SR, Hollenbeck BK, Shahinian VB (2022) Risk of metabolic and cardiovascular adverse events with abiraterone or enzalutamide among men with advanced prostate cancer. J Natl Cancer Inst 114(8):1127\u20131134","journal-title":"J Natl Cancer Inst"},{"issue":"4","key":"5841_CR18","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1038\/s41391-023-00757-0","volume":"27","author":"YHA Lee","year":"2024","unstructured":"Lee YHA, Hui JMH, Leung CH, Tsang CTW, Hui K, Tang P, Chan JSK, Dee EC, Ng K, McBride S, Nguyen PL, Tse G, Ng CF (2024) Major adverse cardiovascular events of enzalutamide versus abiraterone in prostate cancer: a retrospective cohort study. Prostate Cancer Prostatic Dis 27(4):776\u2013782","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"5841_CR19","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-025-03132-8","author":"AS Merseburger","year":"2025","unstructured":"Merseburger AS, Dornstauder E, Ohlmann CH, Aprikian A, Junker S, Hahn P, Chilelli A, Stoelzel M, Serikoff A, Spitzer SG (2025) Cardiovascular risks and survival with abiraterone vs enzalutamide in Chemotherapy-Naive metastatic Castration-Resistant prostate cancer in germany: AVENGER study. Adv Ther. https:\/\/doi.org\/10.1007\/s12325-025-03132-8","journal-title":"Adv Ther"},{"key":"5841_CR20","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/s40264-019-00867-6","volume":"43","author":"NM Schultz","year":"2020","unstructured":"Schultz NM, Penson DF, Wilson S, Song Y, Yang H, Ramaswamy K, Lowentritt B (2020) Adverse events associated with cumulative corticosteroid use in patients with castration-resistant prostate cancer: an administrative claims analysis. Drug Saf 43:23\u201333","journal-title":"Drug Saf"},{"issue":"8","key":"5841_CR21","first-page":"889","volume":"25","author":"NM Schultz","year":"2019","unstructured":"Schultz NM, Penson DF, Wilson SD, Song Y, Yang H, Ramaswamy K, Lowentritt B (2019) Health care resource utilization and costs associated with corticosteroid use in patients with Castration-Resistant prostate cancer: an administrative claims analysis. J Manag Care Spec Pharm 25(8):889\u2013897","journal-title":"J Manag Care Spec Pharm"},{"issue":"1","key":"5841_CR22","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1007\/s00345-024-05280-y","volume":"42","author":"A Bahl","year":"2024","unstructured":"Bahl A, Sodatonou H, Snjider R, Chilelli A, Pranzo A, Martins K, Merseburger A, Rozario N, Crawley D (2024) Enzalutamide versus abiraterone acetate in the development of new-onset or worsening type 2 diabetes mellitus in patients with metastatic castration-resistant prostate cancer: EVADE study. World J Urol 42(1):584","journal-title":"World J Urol"},{"key":"5841_CR23","unstructured":"Electronic Medicines Compendium (2025) Docetaxel 20\u00a0mg\/ml concentrate for solution for infusion summary of product characteristics.\u00a0https:\/\/www.medicines.org.uk\/emc\/product\/7206\/smpc. Accessed 7 Jan 2025"},{"key":"5841_CR24","unstructured":"Electronic Medicines Compendium (2025) Cabazitaxel 60\u00a0mg Concentrate and Solvent For Solution For Infusion summary of product characteristics.\u00a0https:\/\/www.medicines.org.uk\/emc\/product\/12319\/smpc. Accessed: 7 Jan 2025"},{"key":"5841_CR25","doi-asserted-by":"publisher","first-page":"j2099","DOI":"10.1136\/bmj.j2099","volume":"357","author":"J Hippisley-Cox","year":"2017","unstructured":"Hippisley-Cox J, Coupland C, Brindle P (2017) Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease: prospective cohort study. BMJ 357:j2099","journal-title":"BMJ"},{"issue":"12","key":"5841_CR26","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1634\/theoncologist.2014-0167","volume":"19","author":"RJ Auchus","year":"2014","unstructured":"Auchus RJ, Yu MK, Nguyen S, Mundle SD (2014) Use of prednisone with abiraterone acetate in metastatic castration-resistant prostate cancer. Oncologist 19(12):1231\u20131240","journal-title":"Oncologist"},{"key":"5841_CR27","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-024-00889-x","author":"JSK Chan","year":"2024","unstructured":"Chan JSK, Lee YHA, Leung CH, Leung DKW, Dee EC, Ng K, Tse G, Ng CF (2024) Associations between glucocorticoid use and major adverse cardiovascular events in patients with prostate cancer receiving antiandrogen: a retrospective cohort study. Prostate Cancer Prostatic Dis. https:\/\/doi.org\/10.1038\/s41391-024-00889-x","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"5841_CR28","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1016\/j.urology.2016.02.010","volume":"96","author":"M De Santis","year":"2016","unstructured":"De Santis M, Saad F (2016) Practical guidance on the role of corticosteroids in the treatment of metastatic Castration-resistant prostate cancer. Urology 96:156\u2013164","journal-title":"Urology"},{"issue":"41","key":"5841_CR29","doi-asserted-by":"publisher","first-page":"4229","DOI":"10.1093\/eurheartj\/ehac244","volume":"43","author":"AR Lyon","year":"2022","unstructured":"Lyon AR, Lopez-Fernandez T, Couch LS, Asteggiano R, Aznar MC, Bergler-Klein J, Boriani G, Cardinale D, Cordoba R, Cosyns B, Cutter DJ, de Azambuja E, de Boer RA, Dent SF, Farmakis D, Gevaert SA, Gorog DA, Herrmann J, Lenihan D, Moslehi J, Moura B, Salinger SS, Stephens R, Suter TM, Szmit S, Tamargo J, Thavendiranathan P, Tocchetti CG, van der Meer P, van der Pal HJH, Group E.S.C.S.D (2022) 2022 ESC guidelines on cardio-oncology developed in collaboration with the European hematology association (EHA), the European society for therapeutic radiology and oncology (ESTRO) and the international Cardio-Oncology society (IC-OS). Eur Heart J 43(41):4229\u20134361","journal-title":"Eur Heart J"},{"key":"5841_CR30","doi-asserted-by":"publisher","DOI":"10.1200\/OP-24-01045","author":"A Bahl","year":"2025","unstructured":"Bahl A, Faria R, Merseburger AS, Attard G, Snijder R, Sodatonou H, Stark S, Pranzo A, Martins K, Rozario N, Ridsdale-Smith J, Chilelli A (2025) Attributes and health care resource utilization of patients on enzalutamide or abiraterone for metastatic Castration-Resistant cancer in England. JCO Oncol Pract. https:\/\/doi.org\/10.1200\/OP-24-01045","journal-title":"JCO Oncol Pract"}],"container-title":["World Journal of Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00345-025-05841-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00345-025-05841-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00345-025-05841-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T22:03:10Z","timestamp":1767996190000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00345-025-05841-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,1]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["5841"],"URL":"https:\/\/doi.org\/10.1007\/s00345-025-05841-9","relation":{},"ISSN":["1433-8726"],"issn-type":[{"value":"1433-8726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,1]]},"assertion":[{"value":"15 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Amit Bahl has received honoraria from Johnson & Johnson, Astellas, Bayer, ACCORD, and AAA pharmaceuticals, and has received research grants from and has participated in advisory boards for Janssen and Bayer. Andrew Chilelli, Rita Faria, Nigel Rozario, Robert Snijder, and Sari Stark are employees of Astellas Pharma Europe Ltd. Axel Merseburger has received honoraria from Janssen, Astellas, Novartis, Telix, Amgen, Ipsen, Takeda, Recordati, and Bayer.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The data application\/protocol was submitted to and approved by the Independent Scientific Advisory Committee (ISAC) at the Clinical Practice Research Datalink (CPRD), and the linked data were prepared by the CPRD.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"465"}}