2019 Volume 62 Issue 7 Pages 398-405
Case 1 involved a 69-year-old man with prostate cancer with bone metastasis. Abiraterone acetate/steroid combination therapy was started, after which the patient noticed symptoms of hyperglycosemia. Within 1 month, he was hospitalized due to a glycated hemoglobin (HbA1c) level of 8.5 % and a random blood glucose level that had worsened to 400 mg/dL. Case 2 involved an 82-year-old man in whom abiraterone acetate/steroid combination therapy had been started after anti-androgen therapy proved ineffective for prostate cancer. During treatment, his glucose tolerance was not evaluated; he therefore had no subjective symptoms. He was hospitalized for ketosis and an HbA1c level of 9.5 % identified during a checkup performed 9 months after starting the medication. Although no significant decrease in the endogenous insulin level was observed in either case, insulin treatment and glucagon-like peptide 1 (GLP-1) receptor agonist combination were used to correct the hyperglycemia. Abiraterone acetate became available for the treatment of prostate cancer in Japan in 2014. Its use in combination with steroids requires caution due to the risk of exacerbation. We experienced two cases with impaired glucose tolerance after the initiation of treatment and report the situation of their use in our hospital with a review of the literature.
