Teillac Pierre, Heyns Christiaan F, Kaisary Amir V, Bouchot Olivier, Blumberg Joëlle
Centre Hospitalier Universitaire Saint Louis, Paris, France.
Horm Res. 2004;62(5):252-8. doi: 10.1159/000081629. Epub 2004 Oct 19.
The objective of the study was to assess the pharmacodynamic equivalence of LHRH analogue triptorelin 3-month and 28-day SR formulations.
Patients with documented locally advanced or metastatic prostate cancer were randomized to receive one injection of the 3-month formulation (n = 63) or three injections at 28-day intervals of the 28-day formulation (n = 68). Group-chemical castration rates defined as the percentage of patients reaching a testosterone plasma level </=0.5 ng/ml were compared at D84 (i.e., 3 x 28 days). Testosterone, LH and triptorelin plasma profiles, and change from baseline in plasma PSA were assessed over 3 months (from baseline to D91).
Chemical castration rates were 98 and 96% in the 3-month and 28-day formulation groups, respectively, with confidence interval (two-sided 94.2% CI) of [-8.1%; 9.6%]. Median times to reach chemical castration were 18.8 and 18.5 days (p = 0.86, log rank), respectively. Ratios for mean peak plasma levels and AUC(91) of the two formulations for both testosterone and LH fell within the [0.80; 1.25] equivalence interval. Mean PSA decreases from baseline at D91 were 91.0 and 91.7%, respectively (p = 0.73).
Treatments with the two triptorelin formulations over 3 months are pharmacologically equivalent.
本研究的目的是评估促性腺激素释放激素(LHRH)类似物曲普瑞林3个月长效制剂和28天短效制剂的药效学等效性。
有记录的局部晚期或转移性前列腺癌患者被随机分组,分别接受一次3个月长效制剂注射(n = 63)或每隔28天接受三次28天短效制剂注射(n = 68)。在第84天(即3×28天)比较定义为血浆睾酮水平≤0.5 ng/ml的患者百分比的组化学去势率。在3个月内(从基线到第91天)评估睾酮、促黄体生成素(LH)和曲普瑞林的血浆曲线以及血浆前列腺特异性抗原(PSA)相对于基线的变化。
3个月长效制剂组和28天短效制剂组的化学去势率分别为98%和96%,置信区间(双侧94.2% CI)为[-8.1%;9.6%]。达到化学去势的中位时间分别为18.8天和18.5天(p = 0.86,对数秩检验)。两种制剂的睾酮和LH的平均血浆峰浓度和曲线下面积(AUC)(91)的比值均落在[0.80;1.25]等效区间内。在第91天,相对于基线的平均PSA降低率分别为91.0%和91.7%(p = 0.73)。
两种曲普瑞林制剂治疗3个月在药理学上等效。