Wang Jianqing, You Jia, Huang Weixing, Yuan Chiting, Chen Jiangjie, Wang Feifei, Wang Wei, Zhang Liwei
Nephrology department, Taizhou Hospital of Zhejiang Province, Zhejiang University School of Medicine, Taizhou, Zhejiang, China.
School of Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
Front Pharmacol. 2025 Mar 27;16:1570661. doi: 10.3389/fphar.2025.1570661. eCollection 2025.
Androgen antagonists, including apalutamide, darolutamide, and enzalutamide, play a crucial role in the treatment of prostate cancer. This research evaluated the adverse drug reactions (ADRs) associated with the use of these androgen antagonists as reported by the World Health Organization (WHO). Additionally, it compared the adverse drug reaction (ADR) profiles of the three drugs to identify which one presents the lowest risk for individualized patient use.
This study employed a retrospective descriptive analysis design. We collected adverse event reports for three marketed androgen antagonists from WHO-VigiAccess and analyzed them in combination with a bibliometric analysis. We calculated the percentage of adverse reactions reported for each drug to compare the similarities and differences in adverse reactions among the three drugs.
A total of 172,020 adverse events (AEs) associated with three androgen antagonists were reported in VigiAccess at the time of this study. Our findings show apalutamide causes the most endocrine disorders. Darolutamide has the highest rate of blood and lymphatic disorders, while enzalutamide causes the most nervous system disorders. The ten most common ADRs identified were fatigue, rash, death, hot flush, diarrhoea, asthenia, nausea, dizziness, arthralgia, and decreased appetite.
This study utilizes real data from WHO-VigiAccess, which offers valuable insights for clinical reference. On one hand, we confirm both existing and potential adverse effects associated with androgen antagonists. On the other hand, We analyzed the possible future research directions, thereby supporting the case for more scientific treatment.
雄激素拮抗剂,包括阿帕他胺、达罗他胺和恩杂鲁胺,在前列腺癌治疗中发挥着关键作用。本研究评估了世界卫生组织(WHO)报告的与使用这些雄激素拮抗剂相关的药物不良反应(ADR)。此外,还比较了这三种药物的药物不良反应(ADR)特征,以确定哪一种药物在个体化患者使用中风险最低。
本研究采用回顾性描述性分析设计。我们从WHO-VigiAccess收集了三种已上市雄激素拮抗剂的不良事件报告,并结合文献计量分析进行分析。我们计算了每种药物报告的不良反应百分比,以比较三种药物不良反应的异同。
在本研究开展时,VigiAccess共报告了172,020例与三种雄激素拮抗剂相关的不良事件(AE)。我们的研究结果表明,阿帕他胺导致的内分泌紊乱最多。达罗他胺的血液和淋巴系统疾病发生率最高,而恩杂鲁胺导致的神经系统疾病最多。确定的十种最常见的ADR为疲劳、皮疹、死亡、潮热、腹泻、乏力、恶心、头晕、关节痛和食欲下降。
本研究利用了WHO-VigiAccess的真实数据,为临床参考提供了有价值的见解。一方面,我们证实了与雄激素拮抗剂相关的现有和潜在不良反应。另一方面,我们分析了未来可能的研究方向,从而支持更科学治疗的案例。