Side Effects of abiraterone: A Synthesis of Findings from 20 Studies

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Original Abstract of the Article

Major Findings

Abiraterone is an effective treatment option for metastatic castration-resistant prostate cancer (mCRPC). Several studies have shown that abiraterone can significantly improve overall survival (OS) and disease-free survival in patients with mCRPC. However, it is important to note that abiraterone can also cause a variety of side effects, which can impact quality of life. This article summarizes the findings of research on the side effects of abiraterone.

Reasons for Side Effects

Abiraterone is a CYP17A1 inhibitor, which means it blocks the production of testosterone and other androgens. While this is beneficial for treating prostate cancer, it can also have unintended consequences. Abiraterone can lead to a decrease in cortisol levels, which can cause fatigue and weakness. Additionally, it can affect the production of other hormones, potentially leading to mineralocorticoid excess and adrenal insufficiency. 6

Common Side Effects

Hypertension

One common side effect of abiraterone is hypertension. 19 This is likely due to the drug's impact on the production of mineralocorticoids, which can lead to fluid retention and an increase in blood pressure.

Fatigue

Another common side effect of abiraterone is fatigue, often related to a decrease in cortisol production. 19 This can be a significant issue for patients, as it can impact their daily activities and overall quality of life.

Rash

Abiraterone can also cause rash, which may be an allergic reaction to the drug. 19 This side effect can be uncomfortable and sometimes requires medication to manage.

Hot Flushes

Hot flushes are another potential side effect of abiraterone. 19 These sudden feelings of warmth and sweating can be bothersome for some patients.

Cardiac Side Effects

Some research suggests that abiraterone may increase the risk of cardiovascular events, including heart failure. 13 However, more research is needed to understand the full extent of these risks. It is crucial to be aware of this potential side effect and to monitor cardiovascular health closely during abiraterone treatment.

Hepatic Dysfunction

While less common, abiraterone can also cause liver problems. 14 This side effect is usually reversible when the drug is discontinued but requires monitoring with regular liver function tests.

Endocrine Side Effects

Abiraterone can also cause endocrine side effects, such as adrenal insufficiency, which occurs when the adrenal glands do not produce enough hormones. 6 These side effects can be serious and require close monitoring and management by a healthcare professional.

Countermeasures for Side Effects

Hypertension

Hypertension caused by abiraterone can usually be managed with antihypertensive medications. Lifestyle modifications, such as reducing salt intake, increasing physical activity, and maintaining a healthy weight, can also help. 19

Fatigue

Fatigue related to abiraterone may be alleviated with adequate rest, a balanced diet, and regular exercise. In some cases, a healthcare professional may recommend medication to address fatigue. 19

Rash

Rash associated with abiraterone can often be treated with antihistamines or topical steroids. If the rash is severe, the doctor may recommend discontinuing abiraterone therapy. 19

Hot Flushes

Hot flushes can be managed by staying cool, dressing in layers, and avoiding triggers such as spicy foods or alcohol. If hot flushes are severe, a doctor may recommend medication. 19

Cardiac Side Effects

Patients taking abiraterone should be closely monitored for any signs of cardiovascular problems. Regular checkups with a healthcare professional are essential. If cardiac side effects develop, prompt medical attention is crucial. 13

Hepatic Dysfunction

Regular liver function tests are necessary to monitor for liver problems during abiraterone therapy. If liver function is impaired, the doctor may recommend discontinuing the drug. 14

Endocrine Side Effects

Endocrine side effects related to abiraterone can often be managed with hormone replacement therapy. Close monitoring by a healthcare professional is essential. 6

Comparison Between Studies

Common Points of Studies

Multiple studies have shown that abiraterone is an effective treatment for prostate cancer, particularly metastatic castration-resistant prostate cancer (mCRPC). Common side effects reported across these studies include hypertension, fatigue, rash, and hot flushes. 19 13 14 6

Differences Between Studies

The frequency and severity of side effects can vary depending on the study. For example, some research suggests that abiraterone may be associated with a higher risk of heart failure compared to other androgen receptor inhibitors like enzalutamide. 13 However, other studies have found that enzalutamide may have a higher risk of certain side effects. 3 These discrepancies highlight the need for further research to understand the complete side effect profile of abiraterone and other androgen receptor inhibitors.

Points to Note Regarding Application to Real Life

While abiraterone is an effective treatment option for prostate cancer, it is important to be aware of the potential side effects. Before starting treatment with abiraterone, it is crucial to have a detailed discussion with your doctor about the risks and benefits. This includes understanding the potential side effects and how they can be managed. Regular monitoring of health and close communication with your doctor are key to managing any side effects that may develop.

Limitations of Current Research

The research on abiraterone side effects is ongoing, and there are still gaps in our understanding. More research is needed to investigate the long-term impact of abiraterone on cardiovascular health. Additionally, further research is required to explore the full spectrum of abiraterone side effects and how they vary among different individuals and patient populations.

Future Research Directions

Future research efforts should focus on developing strategies to mitigate the side effects of abiraterone. This may involve exploring alternative drug formulations, developing new medications to manage specific side effects, and identifying biomarkers that can help predict which patients are at higher risk of developing certain side effects.

Conclusion

Abiraterone is a valuable treatment option for prostate cancer, but it is essential to be aware of the potential side effects. Open communication with your doctor, regular health monitoring, and proactive management of any side effects are key to maximizing the benefits of this medication while minimizing potential risks.

Literature analysis of 20 papers
Positive Content
18
Neutral Content
1
Negative Content
1
Article Type
2
2
1
4
19
1.

Health-related Quality of Life for Abiraterone Plus Prednisone Versus Enzalutamide in Patients with Metastatic Castration-resistant Prostate Cancer: Results from a Phase II Randomized Trial.

Author: KhalafDaniel J, SunderlandKatherine, EiglBernhard J, KollmannsbergerChristian K, IvanovNikita, FinchDaygen L, OjaConrad, VergidisJoanna, ZulfiqarMuhammad, GleaveMartin E, ChiKim N

HRQoL improvement

Abiraterone was associated with better patient-reported health-related quality of life (HRQoL) and depression symptoms compared to enzalutamide. The study found that differences in the total FACT-P scores were seen only in the elderly patient subgroup.

Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

The LACOG-0415 phase II trial: abiraterone acetate and ADT versus apalutamide versus abiraterone acetate and apalutamide in patients with advanced prostate cancer with non-castration testosterone levels.

Author: WerutskyGustavo, MalufFernando Cotait, CronembergerEduardo Henrique, Carrera SouzaVinicius, Dos Santos MartinsSuelen Patricia, PeixotoFábio, SmaletzOren, SchutzFábio, HerchenhornDaniel, SantosTelma, Mavignier CarcanoFlavio, Queiroz MunizDavid, Nunes FilhoPaulo R S, ZaffaroniFacundo, BarriosCarlos, FayAndré

Prostate cancer treatment
Side effects

This study explores the potential of abiraterone acetate with prednisone (AAP) and apalutamide, both alone and in combination, as hormonal therapies for advanced prostate cancer. The researchers hypothesize that these treatments may be effective in reducing castration-associated side effects, such as sexual dysfunction, osteoporosis, weight gain, and increased cardiovascular risk.

Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

3.

Differential side effects profile in patients with mCRPC treated with abiraterone or enzalutamide: a meta-analysis of randomized controlled trials.

Author: MoreiraRaphael B, DebiasiMarcio, FranciniEdoardo, NuzzoPier V, VelascoGuillermo De, MalufFernando C, FayAndre P, BellmuntJoaquim, ChoueiriToni K, SchutzFabio A

mCRPC treatment
Drug side effects

This meta-analysis compared the risk of adverse events associated with abiraterone and enzalutamide, two drugs approved for the treatment of metastatic castration-resistant prostate cancer (mCRPC).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

4.

[Combination therapy with poly(adenosine diphosphate-ribose) polymerase (PARPi) and androgen receptor signaling pathway (ARPi) inhibitors for metastatic castration-resistant prostate cancer].

Author: GrimmMarc-Oliver, FollerSusan, LeuchtKatharina

mCRPC treatment
Side effects

PARPi plus ARPi combination therapies have been approved for the treatment of metastatic castration-resistant prostate cancer (mCRPC) in patients with BRCA mutations. The article discusses the pivotal clinical trials, potential side effects, and management strategies for these combination therapies.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : German

5.

Small Mitochondria-Targeting Fluorophore with Multifunctional Therapeutic Activities against Prostate Cancer via the HIF1α/OATPs Pathway.

Author: QinJing, ZhangCaiqin, ZhaoYong, TanDengxu, WuPengpeng, ShuiXue, QinWeijun, GeXu, ShiChanghong

PCa treatment
Drug resistance

This study developed two theranostic agents, Abi-DZ-1 and Abi-783, that combine near-infrared fluorescence imaging with targeted drug delivery for the treatment of prostate cancer.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Abiraterone-Induced Endocrinopathies.

Author: DecampsScarlett, LisRita, EkanayakePreethika

Improved prostate cancer survival
Adrenal insufficiency
Mineralocorticoid excess

Abiraterone, a CYP17A1 inhibitor, can cause mineralocorticoid excess and secondary adrenal insufficiency in patients with prostate cancer. This case series emphasizes the importance of monitoring for these endocrine side effects in patients treated with abiraterone.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

8.

A prospective, multicenter study on the clinical effectiveness of abiraterone in metastatic castration-resistant prostate cancer in Korea: Pre- vs. post-chemotherapy.

Author: JeongSeung-Hwan, YeonSang Eun, KimSu Youn, KwonTae Gyun, JeonSeong Soo, ChoiYoung Deuk, KwonDongdeuk, ChungByung Ha, HongSung-Hoo, KimByung Hoon, LeeHyo Jin, ShinSang Joon, ChoiWoo Suk, ParkSung Woo, KangTaek Won, YunSeok Joong, ChoJin Seon, ChoiSee Min, LeeNa-Ri, KwakCheol

mCRPC treatment

This study evaluates the effectiveness and safety of abiraterone acetate plus prednisolone (AAP) in both pre- and post-chemotherapy settings for metastatic castration-resistant prostate cancer (mCRPC). The study utilizes real-world data to assess the optimal treatment sequence for AAP in this patient population.

Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Management of patients with advanced prostate cancer-metastatic and/or castration-resistant prostate cancer: Report of the Advanced Prostate Cancer Consensus Conference (APCCC) 2022.

Author: GillessenSilke, BossiAlberto, DavisIan D, de BonoJohann, FizaziKarim, JamesNicholas D, MottetNicolas, ShoreNeal, SmallEric, SmithMatthew, SweeneyChristopher J, TombalBertrand, AntonarakisEmmanuel S, AparicioAna M, ArmstrongAndrew J, AttardGerhardt, BeerTomasz M, BeltranHimisha, BjartellAnders, BlanchardPierre, BrigantiAlberto, BristowRob G, BulbulMuhammad, CaffoOrazio, CastellanoDaniel, CastroElena, ChengHeather H, ChiKim N, ChowdhurySimon, ClarkeCaroline S, ClarkeNoel, DaugaardGedske, De SantisMaria, DuranIgnacio, EelesRoss, EfstathiouEleni, EfstathiouJason, EkekeOnyeanunam Ngozi, EvansChristopher P, FantiStefano, FengFelix Y, FonteyneValerie, FossatiNicola, FrydenbergMark, GeorgeDan, GleaveMartin, GravisGwenaelle, HalabiSusan, HeinrichDaniel, HerrmannKen, HiganoCelestia, HofmanMichael S, HorvathLisa G, HussainMaha, Jereczek-FossaBarbara A, JonesRob, KanesvaranRavindran, Kellokumpu-LehtinenPirkko-Liisa, KhauliRaja B, KlotzLaurence, KramerGero, LeibowitzRaja, LogothetisChristopher, MahalBrandon, MalufFernando, MateoJoaquin, MathesonDavid, MehraNiven, MerseburgerAxel, MorgansAlicia K, MorrisMichael J, MrabtiHind, MukherjiDeborah, MurphyDeclan G, MurthyVedang, NguyenPaul L, OhWilliam K, OstPiet, O'SullivanJoe M, PadhaniAnwar R, PezaroCarmel J, PoonDarren M C, PritchardColin C, RabahDanny M, RathkopfDana, ReiterRobert E, RubinMark A, RyanCharles J, SaadFred, SadeJuan Pablo, SartorOliver, ScherHoward I, SharifiNima, SkonecznaIwona, SouleHoward, SprattDaniel E, SrinivasSandy, SternbergCora N, SteuberThomas, SuzukiHiroyoshi, SydesMatthew R, TaplinMary-Ellen, TilkiDerya, TürkeriLevent, TurcoFabio, UemuraHiroji, UemuraHirotsugu, ÜrünYüksel, ValeClaire L, van OortInge, VapiwalaNeha, WalzJochen, YamoahKosj, YeDingwei, YuEvan Y, ZapateroAlmudena, ZilliThomas, OmlinAurelius

Improved outcomes

Despite advances in treatment, there is still a lack of high-level evidence to guide clinical practice decisions for advanced prostate cancer. The 2022 Advanced Prostate Cancer Consensus Conference (APCCC 2022) addressed specific questions in these areas.

Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

<sup>225</sup>Ac-PSMA-617 radioligand therapy of de novo metastatic hormone-sensitive prostate carcinoma (mHSPC): preliminary clinical findings.

Author: SathekgeMike, BruchertseiferFrank, VorsterMariza, LawalIsmaheel O, MokoalaKgomotso, ReedJanet, MaseremuleLetjie, NdlovuHonest, HlongwaKhanyi, MaesAlex, MorgensternAlfred, Van de WieleChristophe

mCRPC treatment

This study reports on the use of <sup>225</sup>Ac-PSMA-617, a targeted therapy, in patients with metastatic hormone-sensitive prostate carcinoma (mHSPC) who refused standard treatment options.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

[Androgen deprivation therapy plus chemotherapy ± androgen receptor-targeting agents for metastatic hormone-sensitive prostate cancer].

Author: WenzelMike, HoehBenedikt, ChunFelix K H, MandelPhilipp

Prostate cancer treatment

Androgen deprivation therapy (ADT) has long been the standard of care for metastatic hormone-sensitive prostate cancer (mHSPC). However, recent research has shown that combination therapies, including novel hormone therapies like androgen receptor-targeting agents (ARTAs) and docetaxel chemotherapy, are more effective than ADT alone. Triplet therapies, combining ADT with ARTAs and docetaxel, are also showing promise.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : German

14.

Adverse Events and Androgen Receptor Signaling Inhibitors in the Treatment of Prostate Cancer: A Systematic Review and Multivariate Network Meta-analysis.

Author: CaoBrent, KimMelissa, ReizineNatalie M, MoreiraDaniel M

Improved prostate cancer outcomes
Headache
Hypertension

A systematic review of 14 randomized controlled trials compared the adverse event profiles of four androgen receptor signaling inhibitor (ARSi) drugs (abiraterone, apalutamide, darolutamide, and enzalutamide) for prostate cancer. The review found that the side-effect profiles were similar except for a higher risk of hypertension and headache with enzalutamide. Close blood-pressure monitoring for enzalutamide is recommended.

Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Synthesis and Preclinical Evaluation of Small-Molecule Prostate-Specific Membrane Antigen-Targeted Abiraterone Conjugate.

Author: MachulkinAleksei E, NimenkoEkaterina A, ZykNikolay U, UspenskaiaAnastasiia A, SmirnovaGalina B, KhanIrina I, PokrovskyVadim S, VaneevAlexander N, TimoshenkoRoman V, Mamed-NabizadeVugara V, ZavertkinaMaria V, ErofeevAlexander, GorelkinPetr, MajougaAlexander G, ZykNikolay V, KhazanovaElena S, BeloglazkinaElena K

Prostate cancer treatment
Acute toxicity

A novel PSMA-targeted conjugate based on abiraterone was developed for targeted delivery to prostate cancer cells. The conjugate demonstrated preferential cytotoxicity towards PSMA-expressing prostate tumor cells, showing significant tumor growth inhibition in a xenograft model. Importantly, the conjugate exhibited reduced acute toxicity compared to the parent compound.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

17.

What is the impact of targeted therapies given within phase I trials on the cognitive function of patients with advanced cancer: a mixed-methods exploratory study conducted in an early clinical trials unit.

Author: StapletonSarah, DarlingtonAnne-Sophie Emma, de BonoJ S, WisemanTheresa

Cognitive toxicity
Under-reporting

This protocol outlines an exploratory study to investigate cognitive changes in patients participating in phase I clinical trials. This study aims to address the underreporting of cognitive toxicity, which may lead to incomplete toxicity profiles and unmet patient needs.

Clinical Trial, Phase IThe first stage of clinical trials in humans. Evaluates the safety, tolerability, and pharmacokinetics of a new drug/treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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