Diabetes and Acute Care Use Among Patients With Metastatic Prostate Cancer Treated With Androgen Receptor Signaling...

Area of Science:

• Oncology
• Geriatrics
• Pharmacology

Background:

• Androgen receptor signaling inhibitors (ARSIs) are crucial for metastatic prostate cancer treatment.
• Hyperglycemia is a known side effect of ARSIs, but data on acute care utilization are limited.
• Understanding the impact of diabetes on acute care use in patients on ARSIs is essential for optimizing patient outcomes.

Purpose of the Study:

• To evaluate the association between diabetes and acute care use in elderly patients with metastatic prostate cancer receiving ARSIs.
• To compare acute care utilization rates between diabetic and non-diabetic patients on ARSIs.

Main Methods:

• Utilized SEER-Medicare data for patients aged 66+ with de novo metastatic prostate cancer initiated on abiraterone, enzalutamide, or apalutamide (2010-2017).
• Employed negative binomial regression to calculate incidence rate ratios (IRRs) for acute care use.
• Analyzed total hospital or emergency admissions relative to total time at risk.

Main Results:

• The study included 2,697 patients; 17.4% had diabetes.
• Diabetic patients showed significantly higher acute care use within 6 months (39.9%) compared to non-diabetic patients (27.4%).
• Patients with diabetes had an increased rate of acute care use (IRR=1.38; P=.003), and abiraterone users had higher acute care use (IRR=1.43; P=.005) compared to enzalutamide/apalutamide users.

Conclusions:

• Acute care use is frequent in metastatic prostate cancer patients treated with ARSIs.
• Diabetes is associated with elevated rates of acute care use among patients on ARSIs.
• Further research into interventions for older diabetic patients on ARSIs is warranted.