PMID- 34301529
OWN - NLM
STAT- MEDLINE
DCOM- 20220512
LR  - 20220516
IS  - 2588-9311 (Electronic)
IS  - 2588-9311 (Linking)
VI  - 5
IP  - 2
DP  - 2022 Apr
TI  - The Efficacy and Safety of Relugolix Compared with Degarelix in Advanced Prostate 
      Cancer Patients: A Network Meta-analysis of Randomized Trials.
PG  - 138-145
LID - S2588-9311(21)00122-X [pii]
LID - 10.1016/j.euo.2021.07.002 [doi]
AB  - 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% CrI: 0.07-0.92). In all efficacy ranking analyses, relugolix 
      achieved the best rank. The safety analyses showed that relugolix (RR 0.99, 95% 
      CrI: 0.6-1.6 and RR 0.72, 95% CrI: 0.4-1.3, respectively) and degarelix (RR 1.1, 
      95% CrI: 0.75-1.35 and RR 1.05, 95% CrI: 0.42-2.6, respectively) were not 
      associated with either all AE or serious AE rates. In the ranking analyses, 
      degarelix achieved the worst rank of all AEs and the best rank of serious AEs. 
      Relugolix (RR 0.44, 95% CrI: 0.16-1.2) and degarelix (RR 0.74, 95% CrI: 
      0.37-1.52) were not associated with different cardiovascular event (CVE) rates; 
      both were associated with lower CVE rates than GnRH agonists in the ranking 
      analyses. CONCLUSIONS: We found that the efficacy and safety of relugolix are 
      comparable with those of degarelix, albeit with no injection site reaction. Such 
      data should be interpreted with caution until large-scale direct comparison 
      studies with a longer follow-up are available. PATIENT SUMMARY: We found that 
      relugolix, an oral gonadotropin-releasing hormone (GnRH) antagonist, has 
      comparable efficacy and safety with degarelix, a parenteral GnRH antagonist, for 
      the treatment of advanced prostate cancer patients.
CI  - Copyright (c) 2021 The Author(s). Published by Elsevier B.V. All rights reserved.
FAU - Sari Motlagh, Reza
AU  - Sari Motlagh R
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Men's Health and Reproductive Health Research Center, Shahid 
      Beheshti University of Medical Sciences, Tehran, Iran.
FAU - Abufaraj, Mohammad
AU  - Abufaraj M
AD  - Department of Special Surgery, Jordan University Hospital, the University of 
      Jordan, Amman, Jordan; The National Center for Diabetes, Endocrinology and 
      Genetics, The University of Jordan, Amman, Jordan.
FAU - Mori, Keiichiro
AU  - Mori K
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Department of Urology, The Jikei University School of Medicine, 
      Tokyo, Japan.
FAU - Aydh, Abdulmajeed
AU  - Aydh A
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Department of Urology, King Faisal Medical City, Abha, Saudi 
      Arabia.
FAU - Rajwa, Pawel
AU  - Rajwa P
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Department of Urology, Medical University of Silesia, Zabrze, 
      Poland.
FAU - Katayama, Satoshi
AU  - Katayama S
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Department of Urology, Okayama University Graduate School of 
      Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
FAU - Grossmann, Nico C
AU  - Grossmann NC
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Department of Urology, University Hospital Zurich, Zurich, 
      Switzerland.
FAU - Laukhtina, Ekaterina
AU  - Laukhtina E
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Institute for Urology and Reproductive Health, Sechenov 
      University, Moscow, Russia.
FAU - Mostafai, Hadi
AU  - Mostafai H
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Research Center for Evidence Based Medicine, Tabriz University 
      of Medical Sciences, Tabriz, Iran.
FAU - Pradere, Benjamin
AU  - Pradere B
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria.
FAU - Quhal, Fahad
AU  - Quhal F
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Department of Urology, King Fahad Specialist Hospital, Dammam, 
      Saudi Arabia.
FAU - Karakiewicz, Pierre I
AU  - Karakiewicz PI
AD  - Cancer Prognostics and Health outcomes Unit, University of Montreal Health 
      Center, Montreal, Canada.
FAU - Enikeev, Dmitry V
AU  - Enikeev DV
AD  - Institute for Urology and Reproductive Health, Sechenov University, Moscow, 
      Russia.
FAU - Shariat, Shahrokh F
AU  - Shariat SF
AD  - Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 
      Vienna, Austria; Department of Special Surgery, Jordan University Hospital, the 
      University of Jordan, Amman, Jordan; Institute for Urology and Reproductive 
      Health, Sechenov University, Moscow, Russia; Department of Urology, Weill Cornell 
      Medical College, New York, NY, USA; Department of Urology, University of Texas 
      Southwestern, Dallas, TX, USA; Department of Urology, Second Faculty of Medicine, 
      Charles University, Prague, Czech Republic; Karl Landsteiner Institute of Urology 
      and Andrology, Vienna, Austria. Electronic address: 
      shahrokh.shariat@meduniwien.ac.at.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20210721
PL  - Netherlands
TA  - Eur Urol Oncol
JT  - European urology oncology
JID - 101724904
RN  - 0 (Oligopeptides)
RN  - 0 (Phenylurea Compounds)
RN  - 0 (Pyrimidinones)
RN  - 0 
      (acetyl-2-naphthylalanyl-3-chlorophenylalanyl-1-oxohexadecyl-seryl-4-aminophenylalanyl(hydroorotyl)-4-aminophenylalanyl(carbamoyl)-leucyl-ILys-prolyl-alaninamide)
RN  - 0 (relugolix)
RN  - 33515-09-2 (Gonadotropin-Releasing Hormone)
SB  - IM
MH  - Bayes Theorem
MH  - Gonadotropin-Releasing Hormone/therapeutic use
MH  - Humans
MH  - Male
MH  - Network Meta-Analysis
MH  - Oligopeptides
MH  - Phenylurea Compounds
MH  - *Prostatic Neoplasms/drug therapy
MH  - Pyrimidinones
MH  - Randomized Controlled Trials as Topic
MH  - United States
OTO - NOTNLM
OT  - Degarelix
OT  - Efficacy
OT  - Gonadotropin-releasing hormone agonist
OT  - Gonadotropin-releasing hormone antagonists
OT  - Prostate cancer
OT  - Relugolix
OT  - Safety
EDAT- 2021/07/25 06:00
MHDA- 2022/05/14 06:00
CRDT- 2021/07/24 05:37
PHST- 2021/05/07 00:00 [received]
PHST- 2021/06/06 00:00 [revised]
PHST- 2021/07/01 00:00 [accepted]
PHST- 2021/07/25 06:00 [pubmed]
PHST- 2022/05/14 06:00 [medline]
PHST- 2021/07/24 05:37 [entrez]
AID - S2588-9311(21)00122-X [pii]
AID - 10.1016/j.euo.2021.07.002 [doi]
PST - ppublish
SO  - Eur Urol Oncol. 2022 Apr;5(2):138-145. doi: 10.1016/j.euo.2021.07.002. Epub 2021 
      Jul 21.