Abstract: PD37-04
Sources of Funding: Janssen Scientific Affairs, LLC

Introduction

The literature suggests that statin treatment may influence outcomes for patients across cancers such as pancreatic and breast cancer. Although 30% of men ≥age 40 use statins, little is known about the impact of statins on outcomes for patients treated for mCRPC, particularly the potential for variation in the effect of mCRPC oral treatments. This study examined the association between statin use, mCRPC oral treatments, and patient outcomes in a real-world setting.

Methods

A national health claims database was used to conduct a retrospective study of patients initiated on oral treatments for mCRPC (abiraterone acetate plus prednisone (ABI) or enzalutamide (ENZ)) from 2012-2015. Treatment cohorts and index date were defined based on first medication initiated (ABI/ENZ). Included patients had: ≥1 prostate cancer claim (ICD-9-CM 185.xx) from 6 months pre- to 30 days post-index date; ≥6 month pre-index and ≥3 months post-index health plan enrollment (retaining patients who died). Outcomes assessed included new central-nervous system conditions, bone, brain and visceral metastases, duration of treatment, and mortality. Descriptive analyses and Cox proportional hazards assessed the impact of statins and of ABI/ENZ; models adjusted for age, region, pre-index comorbidities, bone/brain/visceral metastases and docetaxel use.

Results

Follow-up statin use was similar for the cohorts, with 40.82% of 1,095 ABI vs. 38.24% of 421 ENZ treated (P=0.36) patients using statins. The proportion of days covered by statins were 63% (ABI) and 60% ENZ (P=0.16). Follow-up statin use was associated with lower hazards of entering hospice (HR: 0.51, P=0.005), discontinuing oral mCRPC treatments (HR: 0.62, P=0.001), and mortality (HR: 0.54, P <0.001). ABI patients with statins had a lower hazard of CNS events (HR: 0.79; P=0.031), while ENZ patient with statins had a higher hazard of CNS events (HR: 1.09; P=0.026). ENZ patients with follow-up statins had a higher hazard of bone/brain metastases (HR: 1.24, P=0.006).

Conclusions

For a population of real-world patients with mCRPC, statins were associated with improved outcomes and may lead to variability in the effect of oral treatments.

Funding

Janssen Scientific Affairs, LLC