Antiandrogen hepatotoxicity in patients with chronic viral hepatitis
Journal
European Urology
Journal Volume
36
Journal Issue
4
Pages
293-297
Date Issued
1999
Author(s)
Abstract
Objective: To assess whether patients with chronic viral hepatitis are at an increased risk for antiandrogen hepatotoxicity. Methods: We retrospectively reviewed 121 prostate cancer patients who received long-term antiandrogen, either flutamide (n = 56) or cyproterone acetate (n = 65), and had normal pretreatment serum alanine aminotransferase (ALT) levels. Serological markers of hepatitis B and C viruses (HBV and HCV) were checked in 42 of the 121 patients. Results: Twenty-two (18%) of the 121 patients had ALT elevations during antiandrogen therapy. Thirteen (59%) of the 22 patients were positive for either one of the two viral markers, including 7 for HBV, 4 for HCV, and 2 for both. This percentage was higher than the combined prevalence rate of positivity for HBV and/or HCV markers (< 20%) in Taiwan. There was no significant differences in the percentage of positive makers among the two antiandrogen groups (p = 0.092). Although a higher incidence of hepatotoxicity was noted in the flutamide (13/56, 23%) than in the cyproterone acetate group (9/65, 14%), there were no significant differences between the two groups (p = 0.27). The time period between initiation of antiandrogen and first ALT elevation varied significantly (from 4 to 1398 days with a median of 151 days). Half of the 14 HBV carriers and all of the 6 patients with anti-HCV developed antiandrogen hepatotoxicity. Conclusion: Our limited data suggested that patients with chronic viral hepatitis probably are at a higher risk of developing antiandrogen hepatotoxicity. Close monitoring of liver functions in patients with chronic viral hepatitis is advised if antiandrogen therapy is necessary. However, a large-scale study is necessary for a definitive conclusion.
SDGs
Other Subjects
alanine aminotransferase; antiandrogen; cyproterone acetate; flutamide; leuprorelin; triptorelin; aged; alanine aminotransferase blood level; article; chronic disease; disease marker; hepatitis b virus; hepatitis c virus; human; jaundice; liver toxicity; major clinical study; male; priority journal; prostate cancer; retrospective study; virus hepatitis; Aged; Androgen Antagonists; Cyproterone Acetate; Flutamide; Hepatitis B, Chronic; Hepatitis C, Chronic; Humans; Incidence; Liver Diseases; Liver Function Tests; Male; Prostatic Neoplasms; Retrospective Studies
Type
journal article