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Methods: PubMed, Embase, and the Cochrane Library were searched to identify randomized controlled trials; bias was assessed with the Cochrane Risk of Bias tool. Random-effects meta-analysis pooled risk ratios with 95% confidence intervals, with heterogeneity measured by I2, subgroup analyses by ARAT regimen, and publication bias assessed by funnel plots. Results: Eight RCTs (9,298 patients) showed significantly increased all-grade hypokalemia risk with ARATs versus controls, with regimen-specific elevations for abiraterone and combination therapy. Severe hypokalemia risk was also higher with ARAT treatment, strongest in combination regimens. Conclusion: ARAT therapies, especially abiraterone and combination regimens, are associated with increased hypokalemia risk, warranting vigilant potassium monitoring and proactive management.",{"@graph":69,"@context":127},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-impact-of-abiraterone-and-enzalutamide-on-hypokalemia-incidence-in-patients-with-prostate-cancer-a-systematic-review-and-meta-analysis/363779/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-impact-of-abiraterone-and-enzalutamide-on-hypokalemia-incidence-in-patients-with-prostate-cancer-a-systematic-review-and-meta-analysis/363779.png","ImageObject",300,407,{"name":92,"@type":93},"Fans","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-01","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119,123],{"name":110,"@type":111,"acceptedAnswer":112},"What therapies were evaluated for hypokalemia risk in advanced prostate cancer?","Question",{"text":113,"@type":114},"The review evaluated abiraterone, enzalutamide, and their combination as androgen receptor axis-targeted therapies (ARATs).","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was the evidence synthesized in the systematic review and meta-analysis?",{"text":118,"@type":114},"Randomized controlled trials from PubMed, Embase, and the Cochrane Library were included, risk of bias was assessed with the Cochrane tool, and random-effects pooling calculated risk ratios with 95% confidence intervals.",{"name":120,"@type":111,"acceptedAnswer":121},"Did ARAT treatment increase the incidence of hypokalemia compared with controls?",{"text":122,"@type":114},"Yes. The pooled analysis showed a significantly increased risk of all-grade hypokalemia in ARAT-treated patients versus controls.",{"name":124,"@type":111,"acceptedAnswer":125},"What clinical implication did the authors emphasize?",{"text":126,"@type":114},"The authors recommend vigilant monitoring and proactive management of serum potassium levels due to the increased hypokalemia risk.","https://schema.org",{"og:url":83,"og:type":129,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":131,"canonical":83},"index,follow",{"doc_id":133,"site_id":62},363779,1790196474,{"code":4,"msg":5,"data":136},{"doc_id":133,"user_id":137,"nickname":92,"user_avatar":138,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":139,"file_id":140,"file_url":141,"file_type":142,"file_size":143,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":144,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":46},5909892330395,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Lou et al. BMC Cancer (2026) 26:804 BMC Cancer  \n[https://doi.org/10.1186/s12885-026-16108-w](https://doi.org/10.1186/s12885-026-16108-w)  \nRESEARCH Open Access  \nThe impact of abiraterone and enzalutamide on hypokalemia incidence in patients  \nwith prostate cancer: a systematic review and meta-analysis  \nYibo Lou1*†, Dejun Fan2†, Tiejiang Chen1 and Kai Xiong1  \nAbstract  \nObjective To systematically evaluate the incidence of hypokalemia associated with novel androgen receptor axis-targeted therapies (ARATs)—specifically abiraterone, enzalutamide, and their combination—in patients with advanced prostate cancer.  \nMethods A comprehensive search of PubMed, Embase, and the Cochrane Library was conducted to identify published randomized controlled trials (RCTs) . Risk of bias was assessed using the Cochrane Risk of Bias tool. A random-effects model was employed to pool risk ratios (RRs) and 95% confidence intervals (CIs) . Heterogeneity was quantified using the I2 statistic, and subgroup analyses were stratified by the specific ARAT regimen. Publication bias was evaluated utilizing funnel plots.  \nResults Eight unique RCTs (comprising 9 published reports) involving 9,298 patients were included. The overall pooled analysis demonstrated a significantly increased risk of all-grade hypokalemia in patients receiving ARATs compared to controls (RR = 3 . 11, 95% CI: 1 .88–5. 15, P \u003C 0. 001; I2 = 91 . 9%) . Subgroup analyses revealed that this risk was significantly elevated with abiraterone (RR = 3 . 25, 95% CI: 1 .75–6. 02, I2 = 88 . 3%) and the combination of abiraterone plus enzalutamide (RR = 4 . 62, 95% CI: 2 .65–8. 03, I2 = 48 . 6%), but not with enzalutamide (RR = 1 . 16, 95% CI: 0 .96–1. 39) . Similarly, the risk of severe (grade ≥ 3) hypokalemia was significantly higher with ARAT treatment (RR = 4 . 54, 95% CI: 2.42–8. 51, I2 = 48 .4%); the risk signal was strongest in combination regimens (RR = 9 . 34, 95% CI: 1.71–50. 90), although this estimate was based on limited data.  \nConclusion Based on our preliminary findings, ARAT therapies, particularly abiraterone and combination regimens, are significantly related to the increased risk of hypokalemia in patients with advanced prostate cancer. Vigilant monitoring and the proactive management of serum potassium levels are strongly warranted in clinical practice. Keywords Prostate cancer, Androgen receptor axis-targeted therapies, Abiraterone, Enzalutamide, Hypokalemia, Meta-analysis  \n†Yibo Lou and Dejun Fan contributed equally to this work.  \n*Correspondence:  \nYibo Lou [15957917776@163.com](15957917776@163.com)  \n1Department of Emergency, Yiwu Central Hospital, 519 Nanmen Street, Yiwu City, Zhejiang 322000, China  \n2Department of Urology, Chishui People’s Hospital, Chishui,  \nGuizhou 564700, China  \n© The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/licenses/by-nc-nd/4.0/](vecommons.org/licenses/by-nc-nd/4.0/.)[.](vecommons.org/licenses/by-nc-nd/4.0/.)  \nLou et al. BMC Cancer (2026) 26:804  \nIntroduction  \nProst","cbCaingH04E4guJb","https://ap.wps.com/l/cbCaingH04E4guJb","pdf",1014311,"English","# Introduction\n# Methods\n## Search strategy and study selection\n# Results\n# Conclusion","[{\"question\":\"What therapies were evaluated for hypokalemia risk in advanced prostate cancer?\",\"answer\":\"The review evaluated abiraterone, enzalutamide, and their combination as androgen receptor axis-targeted therapies (ARATs).\"},{\"question\":\"How was the evidence synthesized in the systematic review and meta-analysis?\",\"answer\":\"Randomized controlled trials from PubMed, Embase, and the Cochrane Library were included, risk of bias was assessed with the Cochrane tool, and random-effects pooling calculated risk ratios with 95% confidence intervals.\"},{\"question\":\"Did ARAT treatment increase the incidence of hypokalemia compared with controls?\",\"answer\":\"Yes. The pooled analysis showed a significantly increased risk of all-grade hypokalemia in ARAT-treated patients versus controls.\"},{\"question\":\"What clinical implication did the authors emphasize?\",\"answer\":\"The authors recommend vigilant monitoring and proactive management of serum potassium levels due to the increased hypokalemia risk.\"}]","The impact of abiraterone and enzalutamide on hypokalemia incidence in patients with prostate cancer - a systematic review and meta-analysis | PDF",1790153095]