Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Antiandrogen monotherapy may raise dementia risk in patients with prostate cancer

Key clinical point: The use of oral antiandrogen monotherapy, but not gonadotropin-releasing hormone (GnRH) agonists or orchiectomy, is associated with an increased risk for dementia or Alzheimer’s disease (AD).

Major finding: The use of antiandrogen monotherapy was associated with an increased risk for dementia (hazard ratio [HR], 1.34; 95% confidence interval [CI], 1.16-1.55) and AD (HR, 1.52; 95% CI, 1.13-2.04) vs. no androgen deprivation therapy (ADT) use. No significant difference in the risk for dementia or AD was observed with GnRH agonist or orchiectomy vs. no ADT use.

Study details: The data come from a study of 23,651 patients with newly diagnosed prostate cancer (median age, 72 years; 6,904 [29.2%] did not receive ADT, 11 817 [50.0%] received GnRH agonists, 876 [3.7%] received orchiectomy, and 4,054 [17.1%] received antiandrogen monotherapy).

Disclosures: The study was supported in part by grants from the Chang Gung Medical Foundation, Maintenance Project of the Center for Big Data Analytics and Statistics of Chang Gung Memorial Hospital, and the Ministry of Science and Technology, Taiwan. The authors declared no conflicts of interest.


Huang WK et al. JAMA Netw Open. 2020 Aug 3. doi: 10.1001/jamanetworkopen.2020.15189.