ArticleJACC. CardioOncology2023
Cardiovascular Effects of GnRH Antagonists Compared With Agonists in Prostate Cancer: A Systematic Review.
Article in JACC. CardioOncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- A systematic review and meta-analysis of cardiovascular disease risk with degarelix and GnRH agonists in prostate cancer.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Pooled it
- Cardiovascular Complications Associated with Uro-Oncology Treatments-A Primer for the Clinician.Diagnostics (Basel, Switzerland) · 2026Review
- Survivorship Challenges in Metastatic Prostate Cancer in the Era of Prolonged Survival: A Review.Cancers · 2026Review
- [Reassessing androgen deprivation therapy (ADT) in older men with advanced prostate cancer: when to use, when to discontinue, and role as monotherapy?]Urologie (Heidelberg, Germany) · 2026Review
- Multimodality imaging in the detection and management of coronary and peripheral arterial disease in patients with cancer receiving cardiotoxic antineoplastic treatments: A clinical consensus statement of the ESC Council of Cardio-Oncology and the European Association of Cardiovascular Imaging (EACVI) of the ESC.European heart journal. Cardiovascular Imaging · 2026Review
- Shared decision-making in prostate cancer treatment: selecting an androgen deprivation therapy option.Future oncology (London, England) · 2026Review
- Gonadotropin-releasing hormone alleviates chronic pain-related depression in male mice by rebalancing the anterior cingulate cortex excitatory-inhibitory processes via the protein kinase C/Erb-B2 receptor tyrosine kinase 4 pathway.Brain communications · 2026Article
- Cardiovascular Safety Landscape of ADT in Prostate Cancer Treatment Based on Real-World Analysis.Cancer medicine · 2025Article
- Comprehensive review of cardiovascular disease in prostate cancer: epidemiology, risk factors, therapeutics and prevention strategies.Prostate cancer and prostatic diseases · 2025Review
- A 6-month sustained-release formulation of triptorelin for locally advanced or metastatic prostate cancer: a real-world experience in Asia.BMC urology · 2025Article
- Short-term effects of follicle-stimulating hormone on immune function, lipid, and vitamin metabolism in transiently castrated men.Endocrine connections · 2025Article
- Article
- Cardiovascular Safety of GnRH Agonist-Based Androgen Deprivation Therapy in a Real-World Setting: Results from a Prospective Cohort Study (LEAN).Urologia internationalis · 2025Article
- Patients' Preferences for Attributes of Oral vs Injectable Androgen Deprivation Therapy in Prostate Cancer: A Discrete Choice Experiment.Patient preference and adherence · 2025Article
- GnRH Peptide Antagonist: Comparative Analysis of Chemistry and Formulation with Implications for Clinical Safety and Efficacy.Pharmaceuticals (Basel, Switzerland) · 2024Review
- Thrombo-inflammation linking androgen suppression with cardiovascular risk in patients with prostate cancer.Cardio-oncology (London, England) · 2024Review
- Cardiovascular Risk in Prostate Cancer:JACC. CardioOncology · 2024Review
- Cardiovascular Considerations During Cancer Therapy: Gaps in Evidence andJACC. CardioOncology · 2024Review
- Patient Preferences for Attributes of Androgen Deprivation Therapies in Prostate Cancer: A Discrete Choice Experiment with Latent Class Analysis.Advances in therapy · 2024Article
- Cardiovascular disease risk assessment and multidisciplinary care in prostate cancer treatment with ADT: recommendations from the APMA PCCV expert network.World journal of urology · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 15 institutions in 7 countries.
Funding
Abstract
Background: Androgen deprivation therapy is the cornerstone of treatment for patients with advanced prostate cancer. Meta-analysis of small, oncology-focused trials suggest gonadotropin-releasing hormone (GnRH) antagonists may be associated with fewer adverse cardiovascular outcomes compared with GnRH agonists. Objectives: This study sought to determine whether GnRH antagonists were associated with fewer major adverse cardiovascular events compared with GnRH agonists. Methods: Electronic databases were searched for all prospective, randomized trials comparing GnRH antagonists with agonists. The primary outcome was a major adverse cardiovascular event as defined by the following standardized Medical Dictionary for Regulatory Activities terms: "myocardial infarction," "central nervous system hemorrhages and cerebrovascular conditions," and all-cause mortality. Bayesian meta-analysis models with random effects were fitted. Results: A total of 11 eligible studies of a maximum duration of 3 to 36 months (median = 12 months) enrolling 4,248 participants were included. Only 1 trial used a blinded, adjudicated event process, whereas potential bias persisted in all trials given their open-label design. A total of 152 patients with primary outcome events were observed, 76 of 2,655 (2.9%) in GnRH antagonist-treated participants and 76 of 1,593 (4.8%) in agonist-treated individuals. Compared with GnRH agonists, the pooled OR of GnRH antagonists for the primary endpoint was 0.57 (95% credible interval: 0.37-0.86) and 0.58 (95% credible interval: 0.32-1.08) for all-cause death. Conclusions: Despite the addition of the largest, dedicated cardiovascular outcome trial, the volume and quality of available data to definitively answer this question remain suboptimal. Notwithstanding these limitations, the available data suggest that GnRH antagonists are associated with fewer cardiovascular events, and possibly mortality, compared with GnRH agonists.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.