# Comparing the risk of cardiovascular disease between degarelix and gonadotropin-releasing hormone agonists:a systematic review and meta-analysis

## TL;DR

This study compares the cardiovascular risks of degarelix and GnRH agonists in prostate cancer treatment and finds that degarelix may reduce heart failure risk.

## Contribution

The study provides a meta-analysis showing degarelix may lower heart failure risk compared to GnRH agonists.

## Key findings

- Degarelix showed no significant difference in major cardiovascular events compared to GnRH agonists.
- Degarelix reduced the risk of heart failure compared to GnRH agonists.
- More research is needed to clarify cardiovascular effects of androgen deprivation therapies.

## Abstract

Regarding the comparison of cardiovascular disease risk between gonadotropin-releasing hormone (GnRH) antagonists and GnRH agonists, there are discrepancies in results from different studies. Therefore, this meta-analysis was conducted to investigate whether degarelix could reduce cardiovascular disease risk.

We systematically searched the PubMed, Embase, Web of Science, and Cochrane Library databases with a search time limit of up to December 2023 for articles focusing on the use of degarelix, a GnRH antagonist, in prostate cancer, with an emphasis on articles comparing degarelix to GnRH agonists. Study endpoints included major adverse cardiovascular events, stroke, all-cause mortality, myocardial infarction, heart failure, and arrhythmia.

A total of 1320 articles were retrieved, of which eight met our inclusion criteria and involved 138–065 patients. The pooled results showed no difference in the risk of major adverse cardiovascular events (hazard ratio [HR]=0.94, 95% confidence interval [CI]: 0.65–1.35; P=0.73), stroke (HR=0.89, 95% CI: 0.62–1.27; P=0.52), myocardial infarction (HR=0.98, 95% CI: 0.70–1.37; P=0.91), all-cause mortality (HR=1.09, 95% CI: 0.73–1.65; P=0.67), and arrhythmia (risk ratio=0.64, 95% CI: 0.15–2.76; P=0.55) between degarelix and GnRH agonists. However, degarelix reduced the risk of heart failure (HR=0.56, 95% CI: 0.36–0.88; P=0.01).

Further clarification on the effects of different androgen deprivation therapy modalities on cardiovascular disease is needed from future and larger prospective randomized controlled trials.