abiraterone + prednisolone

Abiraterone + prednisolone is a combination therapy used primarily in the treatment of **metastatic castration-resistant prostate cancer (mCRPC)** and **metastatic high-risk castration-sensitive prostate cancer (mCSPC)**. Abiraterone (administered as abiraterone acetate) is a selective, irreversible inhibitor of the enzyme **steroid 17-hydroxylase/17,20-lyase (CYP17A1)**, a key enzyme in androgen biosynthesis, primarily targeted to reduce androgen production from adrenal glands and the tumor microenvironment. Its inhibition lowers both testosterone and cortisol production, leading to a compensatory increase in mineralocorticoid precursors, adrenocorticotropic hormone (ACTH), and associated mineralocorticoid excess (hypertension, hypokalemia, fluid retention). Prednisolone, a synthetic glucocorticoid, is co-administered low-dose (typically 5 mg twice daily) to **replace cortisol and suppress ACTH**, thereby mitigating side effects related to mineralocorticoid excess. This combination improves survival in mCRPC and mCSPC, with a safety profile in which adverse events are generally low and manageable, mostly at grade 1 or 2 severity[1][3][4].

Other names

abiraterone acetate + prednisolone