| Abstract | Cilj: Ispitati koje su najčešće nuspojave nove hormonske terapije u liječenju karcinoma prostate prijavljene u svakodnevnoj kliničkoj praksi te utvrditi razlikuje li se profil toksičnosti ovisno lijeku. Izvori podataka i metode: Za izradu ovog rada korištena je baza podataka MEDLINE putem PubMed-a koristeći ključne riječi: „prostate cancer“, „novel hormonal therapy“, „antiandrogens“, „side effects“, „safety“ i „real-world“. Prilikom pretraživanja literature uzeti su u obzir radovi objavljeni na engleskom jeziku. Odbačeni su radovi ograničeni isključivo na geografsko područje Azije i radovi koji zbog vrste terapije koju opisuju u svojim rezultatima tematski ne odgovaraju našem preglednom radu. Rezultati: Pregledom literature pronađen je ukupno 21 rad u bazi podataka MEDLINE putem PubMed-a koji odgovara temi pretraživanja. Dva rada opisivala su nuspojave abirateron-acetata te dva rada nuspojave enzalutamida, dok je devet radova uspoređivalo ta dva lijeka. Tri rada opisivala su nuspojave apalutamida, dva rada nuspojave darolutamida te jedan rad usporedbu enzalutamida, apalutamida i darolutamida. Rasprava: Abirateron-acetat je uz lakše nuspojave poput hipertenzije i perifernih edema pokazao određenu razinu kardiotoksičnog učinka, dok je kod enzalutamida osim izrazitog umora, mučnine i navala vrućine zabilježen neurotoksičan učinak. Stopa hospitalizacija zbog ozbiljnih nuspojava znatno je veća kod abirateron-acetata u usporedbi s enzalutamidom. Apalutamid i darolutamid pokazali su značajno manje nuspojava, međutim pojava osipa kože, hipertenzije i prijeloma nije izostala kod primjene apalutamida, kao ni pojava artralgija, boli u leđima i umora kod primjene darolutamida. Padovi, prijelomi i osipi kože su statistički značajno učestaliji kod apalutamida nego kod darolutamida, dok su padovi, vrtoglavica, epileptički napadaji i umor statistički značajno rjeđi kod darolutamida nego kod enzalutamida. Zaključci: Prema pregledanoj literaturi, potvrđen je povoljan profil toksičnosti nove hormonske terapije kod primjene u svakodnevnoj kliničkoj praksi, ranije dokazan u kliničkim ispitivanjima kod pacijenata s karcinomom prostate. |
| Abstract (english) | Objective: To examine the most common side effects of novel hormonal therapy in the treatment of prostate cancer reported in real-world settings and to determine whether the toxicity profile differs depending on the drug. Data sources and methods: The MEDLINE database via PubMed was used to produce this paper using the keywords: "prostate cancer", "novel hormonal therapy", "antiandrogens", "side effects", "safety" and "real world". During the literature search, works published in English were taken into account. Papers limited exclusively to the geographical area of Asia and papers that, due to the type of therapy described in their results, do not thematically match our review paper were rejected. Results: A literature review found a total of 21 papers in the MEDLINE database via PubMed that correspond to the search topics. Two papers described the side effects of abiraterone acetate and two papers the side effects of enzalutamide, while nine papers compared the two drugs. Three papers described side effects of apalutamide, two papers described side effects of darolutamide, and one paper compared enzalutamide, apalutamide and darolutamide. Discussion: Abiraterone-acetate, along with minor side effects such as hypertension and peripheral edema, showed a certain level of cardiotoxic effect, while with enzalutamide, in addition to extreme fatigue, nausea and hot flushes, a neurotoxic effect was recorded. The rate of hospitalization due to serious adverse events is significantly higher with abiraterone acetate compared with enzalutamide. Apalutamide and darolutamide showed significantly fewer side effects, however, skin rashes, hypertension and fractures did occur with apalutamide, as did arthralgia, back pain and fatigue with darolutamide. Falls, fractures and skin rashes are statistically significantly more frequent with apalutamide than with darolutamide, while falls, dizziness, epileptic seizures and fatigue are statistically significantly less frequent with darolutamide than with enzalutamide. Conclusions: According to the reviewed literature, the favorable toxicity profile of the novel hormonal therapy in real-world use, previously proven in clinical trials in patients with prostate cancer, was confirmed |
