Neurotoxicities of novel non-steroidal anti-androgens for prostate cancer: A systematic review and meta-analysis.

Abstract Introduction Novel non-steroidal anti-androgens (NSAA) are increasingly part of the management of prostate cancer. We aimed to quantify and compare the neurologic side effects of NSAA agents. Materials and methods Phase III randomized controlled trials evaluating NSAAs in the treatment of prostate cancer were selected by two reviewers independently in MEDLINE. A random-effects model and the Mantel-Haenszel method were used. The Odds Ratio (OR) and its 95 % confidence interval were computed. The primary endpoints were the rates of neurologic adverse events. Results Eight phase III trials evaluating novel NSAAs (vs. non-NSAAs) were included. Fatigue (OR:1.66 [1.32–2.08]), falls (OR:1.76 [1.25–2.49]), headache (OR:1.74 [1.42–2.14]), and dizziness (OR:1.70 [1.33–2.19]) were found to be significantly associated with NSAA use. Conclusions NSAAs are associated with an increase in various neurologic adverse events. When NSAAs are prescribed, neurologic adverse event prevention and management strategies should be discussed and implemented.