Degarelix versus Goserelin plus Bicalutamide Therapy for Lower Urinary Tract Symptom Relief, Prostate Volume Reduction and Quality of Life Improvement in Men with Prostate Cancer: A Systematic Review and Meta-Analysis

Cui, Yuanshan; Zong, Huantao; Yan, Hong; Li, Nan; Zhang, Yong

doi:10.1159/000356272

Cited by 23 publications

(21 citation statements)

References 22 publications

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“…This study was consistent with previous reports of the beneficial effects of goserelin on LUTS . However, in another study, reductions in IPSS were greater in patients treated with the GnRH antagonist degarelix than in those receiving the combination of goserelin and bicalutamide . Recent non‐interventional studies have suggested an improvement in LUTS induced by triptorelin, as measured by the IPSS .…”

Section: Discussionsupporting

confidence: 91%

Are all gonadotrophin‐releasing hormone agonists equivalent for the treatment of prostate cancer? A systematic review

Bolton

Lynch

2018

BJU International

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To review direct comparative studies of the gonadotrophin-releasing hormone (GnRH) agonists goserelin, triptorelin, and leuprorelin for the treatment of prostate cancer, and identify whether there are meaningful clinical differences between these agents. In June 2017, the following searches were performed independently by two reviewers in PubMed: (i) 'prostate cancer' and 'triptorelin' and 'leuprorelin', (ii) 'prostate cancer' and 'triptorelin' and 'goserelin', and (iii) 'prostate cancer' and 'goserelin' and 'leuprorelin', without time restriction. Duplicates were deleted. Relevant conference abstracts were also screened. A total of 16 direct comparative trials were identified: 12 reported on efficacy outcomes, four on safety/tolerability, and five on the convenience of administration/user perceptions. These studies are restricted in terms of patient numbers, formulations assessed, and endpoints measured; none were adequately powered for survival outcome measures. Studies reporting on efficacy endpoints did not show major differences in the ability of these GnRH agonists to reduce levels of testosterone or prostate-specific antigen. Some studies suggest differences in short- or long-term testosterone control, the rate of injection site adverse events, and patient/healthcare professional perceptions, but definitive conclusions cannot be drawn from the existing evidence. Few direct comparative trials of GnRH agonists have been conducted. Whilst GnRH agonists provide a similar castration effect, there is not enough evidence to show that GnRH agonists are equivalent.

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Section: Discussionsupporting

confidence: 91%

Are all gonadotrophin‐releasing hormone agonists equivalent for the treatment of prostate cancer? A systematic review

Bolton

Lynch

2018

BJU International

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“…Furthermore, the GnRH antagonist degarelix had a greater impact on LUTS at 12 weeks compared with the GnRH agonist goserelin, despite similar effects on PSA and testosterone suppression, which may suggest the mechanism on LUTS is independent of these markers Anderson et al 2013;Mason et al 2013;Cui et al 2014]. Although prostate volume was not measured in this observational study, there was a clear correlation between PSA suppression and LUTS improvement in this large cohort of patients.…”

Section: Discussionmentioning

confidence: 70%

A prospective, observational grouped analysis to evaluate the effect of triptorelin on lower urinary tract symptoms in patients with advanced prostate cancer

Gil

Aoun

Cabri

et al. 2015

Therapeutic Advances in Urology

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Objectives: Few studies have assessed the effect of gonadotropin-releasing hormone (GnRH) agonists, such as triptorelin, on lower urinary tract symptoms (LUTS) in patients with advanced prostate cancer. Therefore, multiple, national observational, noninterventional studies were initiated to assess the effectiveness of triptorelin in reducing moderate or severe LUTS [International Prostate Symptom Score (IPSS) >7] in men with prostate cancer starting triptorelin therapy in clinical practice. Methods: Prospective, noninterventional, multicentre studies of LUTS located in Algeria, Belgium, China, Hungary, Romania and South Korea, in patients who were scheduled to receive triptorelin (3-month extended release or 1-month formulation) in clinical practice. The primary effectiveness endpoint was the proportion of patients with moderate or severe LUTS after 48 weeks as assessed by IPSS. Secondary endpoints included the distribution of IPSS categories, total IPSS and prostate-specific antigen (PSA) levels at baseline, 24 and 48 weeks. Results: In total, 2461 patients were recruited in the studies; 1282 patients had moderate or severe LUTS at baseline (IPSS > 7), received triptorelin and had follow-up IPSS. Mean total IPSS was reduced from 18.2 [95% confidence interval (CI) 17.8-18.5] at baseline to 11.9 (95% CI 11.5-12.3; p < 0.001) and 10.6 (95% CI 10.2-11.0; p < 0.001) at weeks 24 and 48, respectively. Mean PSA levels were reduced from 117.9 ng/ml (95% CI 93.8-141.9) at baseline to 8.5 ng/ml (95% CI 5.2-11.7) and 16.6 ng/ml (95% CI 7.4-25.8) at weeks 24 and 48, respectively. There was a significant correlation between total IPSS change from baseline and PSA change from baseline at weeks 24 and 48 (ρ = 0.3 and 0.2, p < 0.001). Conclusions:The improvement in LUTS in men with locally advanced or metastatic prostate cancer after 24-48 weeks suggests that triptorelin is effective in improving LUTS in this subgroup of patients.

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“…In the past years, numerous studies have been carried out to identify risk factors associated with the etiology and pathogenesis of BPH [10,12,19,20]. Rohrmann et al [12] aimed to identify the relationship between smoking and BPH, but there was no statistical association.…”

Section: Discussionmentioning

confidence: 99%

“…Age, genetic, and hormonal factors have been traditionally considered as the main risk factors for BPH and its associated pathophysiology, but lifestyle elements such as PA, leisure, exercise, smoking, and drinking are now considered to play an important role in the development of BPH [10,11,12,13]. The importance of PA in the prevention of chronic diseases, including metabolic syndrome, has been suggested from several epidemiologic studies in which PA was shown to have a protective effect.…”

Section: Introductionmentioning

confidence: 99%

The Study About Physical Activity for Subjects With Prevention of Benign Prostate Hyperplasia

et al. 2014

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PurposeThe number of benign prostatic hyperplasia (BPH) subjects has been increasing worldwide, and many studies have been conducted to determine the treatment that can delay drug therapy or surgery. Subsequently, most of these studies involved physical activity (PA) and associated factors. Therefore, we aimed to determine factors associated with BPH prevalence based on a review of past and present studies and to investigate the effect of a healthy lifestyle as a protective factor of BPH occurrence.MethodsWe selected 582 subjects aged ≥40 years from an initial 779 subjects recruited from Gyeonggi, Yangpyeong, South Korea, during August 2009 to August 2011. Trained investigators surveyed International Prostate Symptom Score and demographic information, including PA and lifestyle questionnaire during face-to-face interviews; further, they performed digital rectal examination, rectal ultrasonography, and measured prostate-specific antigen levels. The statistical association between PA and BPH was analyzed by logistic regression analysis using multivariable regression models which use categorical variables by the Cochran-Mantel-Haenszel test and continuous variables by the general linear model.ResultsSeven statistically significant variables for PA were selected. Regular exercise, frequency of exercise, sedentary time, nonsedentary time, leisure time PA (metabolic equivalent, hr/wk) were not statistically associated with prostate volume but sedentary time (hr/day) was the only factor that showed a significant association in the multivariable model, including a linear effect relationship. Subjects with lower levels of sedentary time (4.5-7.0 hr/day) had a significantly lower risk of BPH (odds ratio [OR], 0.93; 95% confidence interval [CI], 0.52-1.67) than those with a higher sedentary time (>7 hr/day) (OR, 1.72; 95% CI, 0.96-3.09) (P for trend=0.05).ConclusionsOur study showed that reducing sedentary time could have a protective effect and reduce the prevalence of BPH. Further prospective studies with a larger sample size are needed to assess the impact of reducing sedentary time on BPH risk.

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Degarelix versus Goserelin plus Bicalutamide Therapy for Lower Urinary Tract Symptom Relief, Prostate Volume Reduction and Quality of Life Improvement in Men with Prostate Cancer: A Systematic Review and Meta-Analysis

Cited by 23 publications

References 22 publications

Are all gonadotrophin‐releasing hormone agonists equivalent for the treatment of prostate cancer? A systematic review

Are all gonadotrophin‐releasing hormone agonists equivalent for the treatment of prostate cancer? A systematic review

A prospective, observational grouped analysis to evaluate the effect of triptorelin on lower urinary tract symptoms in patients with advanced prostate cancer

The Study About Physical Activity for Subjects With Prevention of Benign Prostate Hyperplasia

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