Second-generation antiandrogens ― abiraterone, apalutamide, darolutamide, and enzalutamide ― are a cornerstone of modern prostate cancer treatment, improving outcomes and survival.
The study fills a"critical gap" when it comes to counseling men about the drugs and will help guide discussions, they say.
The rates of adverse cognitive effects and attention disorders and disturbances ranged from 2% to 8% among patients who received second-generation AAs, vs 2% to 3% among those who received placebo, a more than doubling of the risk of cognitive toxic effects . The use of AAs was associated with an 87% increase in the risk of falls in comparison with placebo, regardless of severity. For falls of grade 3 or higher that required hospitalization or invasive treatment, the increase in risk with second-generation AAs was 72% .
Study limits include the fact that it was not known how long patients were taking the drugs before they encountered problems. In addition, the findings were not broken down with respect to medication, so it's unknown whether such problems are worse with some second-generation AAs than with others.
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