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<p>This meta-analysis aimed to systematically evaluate the incidence and risk of dizziness associated with novel endocrine therapies (androgen receptor pathway inhibitors, ARPIs) in patients with advanced prostate cancer. A comprehensive literature search was conducted across PubMed, Web of Science, and ClinicalTrials.gov databases. After screening titles/abstracts and full-texts, 4 eligible randomized controlled trials (RCTs) involving 4267 patients were included. Risk of bias assessment was performed using the Cochrane Risk of Bias (RoB 2) tool. Meta-analysis results indicated that ARPI-based therapy was significantly associated with an increased risk of all-grade dizziness (risk ratio [RR] = 1.60, 95% confidence interval [CI]: 1.28–2.00, I<sup>2</sup> = 18.7%, <i>p</i> = 0.2955) compared with control. For grade ≥ 3 dizziness, the pooled RR was 2.03 (95% CI: 0.56–7.29, I<sup>2</sup> = 0.0%, <i>p</i> = 0.8165), though statistical significance was not reached. Subgroup analyses by ARPI type (abiraterone [Abi], Abi + enzalutamide [Enz], darolutamide [Dar], Enz) showed no significant differences in dizziness risk among subgroups (<i>p</i> = 0.2026). In conclusion, novel endocrine therapy with ARPIs increases the risk of all-grade dizziness in prostate cancer patients, while the risk of severe dizziness remains non-significant. Clinicians should monitor dizziness symptoms during ARPI treatment to optimize patient management.</p>

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A meta-analysis of dizziness as an adverse reaction in novel endocrine therapy for advanced prostate cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月1日

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  • Wenbin Xue,
  • Pu Zhang,
  • Jing Quan

摘要

This meta-analysis aimed to systematically evaluate the incidence and risk of dizziness associated with novel endocrine therapies (androgen receptor pathway inhibitors, ARPIs) in patients with advanced prostate cancer. A comprehensive literature search was conducted across PubMed, Web of Science, and ClinicalTrials.gov databases. After screening titles/abstracts and full-texts, 4 eligible randomized controlled trials (RCTs) involving 4267 patients were included. Risk of bias assessment was performed using the Cochrane Risk of Bias (RoB 2) tool. Meta-analysis results indicated that ARPI-based therapy was significantly associated with an increased risk of all-grade dizziness (risk ratio [RR] = 1.60, 95% confidence interval [CI]: 1.28–2.00, I2 = 18.7%, p = 0.2955) compared with control. For grade ≥ 3 dizziness, the pooled RR was 2.03 (95% CI: 0.56–7.29, I2 = 0.0%, p = 0.8165), though statistical significance was not reached. Subgroup analyses by ARPI type (abiraterone [Abi], Abi + enzalutamide [Enz], darolutamide [Dar], Enz) showed no significant differences in dizziness risk among subgroups (p = 0.2026). In conclusion, novel endocrine therapy with ARPIs increases the risk of all-grade dizziness in prostate cancer patients, while the risk of severe dizziness remains non-significant. Clinicians should monitor dizziness symptoms during ARPI treatment to optimize patient management.