Efficacy of Leuprorelide acetate (Eligard®) in daily practice in Brazil: a retrospective study with depot formulations in patients with prostate cancer

Abstract

Introduction: Androgen deprivation therapy (ADT) is the mainstay of therapy for advanced prostate cancer. Studies addressing the effi cacy of different depot formulations of long acting luteinizing hormone releasing hormone agonists in the Brazilian population are lacking. We aimed to compare the effi cacy of three schedules of leuprolide acetate in lowering PSA in a real world population. Materials and Methods: We reviewed the medical records of patients with prostate cancer seen at our institution between January 2007 and July 2018. We analyzed patients treated with long-acting leuprolide acetate and grouped these patients into three strata according to the administration of ADT every 1, 3 or 6 months. The primary outcome was the serum prostate specifi c antigen (PSA) levels at 6 and 12 months after treatment initiation. We used Friedman test to compare the distribution of PSA levels at baseline and at 6 and 12 months within each treatment stratum. We considered two-sided P values <0.05 as statistically signifi cant. We analyzed toxicity descriptively. Results: We analyzed a total of 932 patients, with a median age of 72 years and a median time since diagnosis of prostate cancer of 8.5 months. ADT was administered monthly in 115 patients, quarterly in 637, and semiannually in 180. Nearly half of the patients had locally advanced disease. In comparison with baseline, median serum PSA levels were reduced at 12 months by at least 99.7% in the three strata (P <0.001 in all cases). Sexual impotence and hot fl ashes were the most frequently reported toxicities. Conclusion: To our knowledge, this is the largest assessment of real-world data on alternative schedules of leuprolide in a Brazilian population. Our study suggests that PSA levels can be effectively be reduced in most patients treated with monthly, quarterly, or semiannual injections of long-acting leuprolide acetate.

Treatment of complex urethral stenosis in public centers from developing countries in 21st century

“…Nowadays, urethroplasties require years of study to obtain the most lasting results, and some authors consider proficiency as occurring after around 100 surgeries (12). Thus, it may be that urethroplasties are underutilized due to lack of training or access to a trained colleague (13,14).…”

“…Incomplete posterior urethral lesions can be treated with bladder catheterization, however, there is a risk of it turning into a complete lesion, where treatment options are immediate primary surgical reconstruction (currently abandoned due to high rates of erectile dysfunction, incontinence, stenosis and intraoperative bleeding), primary realignment in stable patients (which decreases rates of stenosis and incontinence and is the choice in several referral services) or supra-pubic urinary diversion and late reconstruction (classic and often mandatory management due to the clinical instability of polytrauma patients) (6,12), with urethral stenosis as the rule in the latter case. Late posterior perineal urethroplasty has high success rates and avoids the need for multiple procedures (17,18).…”

Construction and evaluation of a phospholipid-based phase transition in situ gel system for brexpiprazole

“…Currently, available gel injections included OncoGel®, Eligard®, AtridoxElyzol®, SomatulineDepot®, etc. All these gel injections provided a delayed release and prolonged the duration of action [15][16][17]. This strategy may also apply to enhancing treatment outcomes in schizophrenia.…”

Perception of castration value over cost in the metastatic prostate cancer scenario: a contemporary pharmacoeconomic perspective

“…To further understand the underuse of surgical castration (12) even among urologists, we consecutively and anonymously interviewed one hundred urologists during a urology meeting. They answered a survey with multiple-choice questions regarding their perceptions of value, cost, and pharmacoeconomic issues concerning metastatic prostate cancer castration treatment.…”