The Efficacy and Safety of Relugolix Compared with Degarelix in Advanced Prostate Cancer Patients: A Network Meta-analysis of Randomized Trials

Abstract

Context: Degarelix is associated with high rates of injection site reaction. The US Food and Drug Administration approved relugolix, an oral gonadotropin-releasing hormone (GnRH) antagonist, for the treatment of advanced prostate cancer patients. Objective: This systematic review and network meta-analysis aimed to compare the efficacy and safety of relugolix versus degarelix. Evidence acquisition: A systematic search was performed using major web databases for studies published before January 30, 2021, according to the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) extension statement for a network meta-analysis. Studies that compared the efficacy (12-mo castration rate with testosterone 50 ng/dl) and safety (adverse events [AEs]) of relugolix or degarelix and of the control group (GnRH agonists) were included. We used the Bayesian approach in the network meta-analysis. Evidence synthesis: Four studies (n = 2059) met our eligibility criteria. The main efficacy analysis was conducted for two different treatments (relugolix and all doses of degarelix vs GnRH agonists); relugolix (risk ratio [RR] 1.09, 95% credible interval [CrI]: 0.95-1.23) and degarelix (RR 0.98, 95% CrI: 0.91-1.06) were not associated with different 12-mo castration rates. In the subgroup analysis, degarelix 480 mg was significantly associated with a lower castration rate (RR 0.46, 95%

Relugolix: A Review in Advanced Prostate Cancer

“…2 ); however, all cases were mild or moderate in severity and no cases led to withdrawal from the study [ 12 ]. On the other hand, the oral route of administration of relugolix avoids the potential for injection-site reactions [ 21 ], which can be a concern for injectable ADT agents such as degarelix [ 8 , 25 ].…”

Radiation therapy compared to radical prostatectomy as first-line definitive therapy for patients with high-risk localised prostate cancer: An updated systematic review and meta-analysis

“…Some single institution and small cohorts included in this systematic review tried to conduct a fair comparison between those strategies (i.e. RP plus adjuvant/salvage RT and ADT) [ 17 , 19 , 36 , 37 ]; however, the inherent selection bias limits any fair comparisons ( Table 2 ), this is especially true for in multi-institutional and population-based datasets and registries, while they are at least likely to suffer from systematic bias based on their geographic and specialty representativeness.…”

Androgen Deprivation Therapy in Prostate Cancer: A Practical Approach to Complex Clinical Scenarios

“…Suardi reminded the audience that there is only little or no difference in efficacy between LHRH agonists and antagonists, in terms of controlling testosterone levels, [5][6][7] or preventing PSA progression. 7,8 However, there appears to be some disparity between the two drug classes in terms of CV risk.…”