This study compared the effectiveness and safety of enzalutamide (ENZA) and abiraterone acetate (AA) in treating metastatic castration-resistant prostate cancer (mCRPC) using real-world data from two German claims databases (AOK PLUS and GWQ ServicePlus).
The primary aim was to evaluate the cardiovascular (CV) event risk and overall survival (OS) in chemotherapy-naïve patients initiating either ENZA or AA between 2012 and 2020. The study employed propensity score matching (PSM) to balance the baseline characteristics of both groups. The results indicated that ENZA was associated with a significantly lower risk of CV events, fewer recurrent CV events, and a reduced CV event rate compared to AA. Furthermore, ENZA patients experienced improved overall survival.
The study included 2240 patients, with 828 in the ENZA group and 1412 in the AA group. After applying PSM, 796 patients were included in each group, accounting for differences in age and comorbidities. The findings showed that ENZA patients had a lower risk of CV-related hospitalization, with a hazard ratio of 0.70 (95% CI 0.57–0.86, p = 0.001), a reduced CV event rate (0.17 vs. 0.23 per person-year, p = 0.006), and prolonged OS (HR 0.79, 95% CI 0.71–0.89, p < 0.001) compared to AA. The study concluded that ENZA offers better cardiovascular safety and longer survival benefits over AA for patients with mCRPC.