Radiation Oncology Department, Instituto Medicina Oncológica y Molecular de Asturias, Oviedo, Spain.
BJU Int. 2011 Apr;107(8):1200-8. doi: 10.1111/j.1464-410X.2010.09827.x. Epub 2010 Nov 15.
What's known on the subject? and What does the study add? Luteinizing hormone-releasing hormone analogues are a cornerstone in the management of many clinical situations in prostate cancer patients. The multiplicity of drugs make it difficult to decide which is the best drug to prescribe to each patient. Whether or not the different luteinizing hormone-releasing hormone analogues belong to the same drug class is only merely supposed. This study adds a systematic review of the literature in order to determine whether or not the luteinizing hormone-releasing hormone analogues available for prescription belong to the same drug class (same family, similar chemical structure, mechanism of action, and efficacy). The current evidence available is not enough to support a presumed drug class effect of the various analogues in the treatment of prostate carcinoma.
• To study whether luteinizing hormone-releasing hormone (LHRH) analogues are agents of the same pharmacological class, i.e. whether they have the same clinical effect, using an evidence-based medicine approach.
• We reviewed the evidence on the alleged 'drug class effect' among analogues and the existing bibliographic support for their use in various medical indications. We used PubMed as the main search source. Evidence level and degree of recommendation were assigned to each conclusion based on the 'Scottish Intercollegiate Guidelines Network'.
• There are no studies designed to answer the question of class effect between LHRH analogues or agonists. Reviews and meta-analyses have been performed on many other issues related to therapeutic management either with analogues alone, or in combination with radiation therapy and surgery. • Direct comparisons do not allow definitive conclusions to be reached. Indirect evidence is obtained from randomized studies comparing the different LHRH analogues with other treatments used to obtain androgen deprivation. Other issues related to pharmacokinetics and pharmacodynamics that can support either the existence or non-existence of class effect were evaluated.
• The current available evidence is not enough to support a presumed class effect of the drug among the different analogues in the treatment of prostate carcinoma in its various clinical situations.
• 采用循证医学方法研究黄体生成素释放激素（LHRH）类似物是否为同一类药物，即它们是否具有相同的临床效果。
• 我们回顾了关于类似物中所谓“药物类别效应”的证据，以及现有文献支持它们在各种医学适应症中的应用。我们主要使用 PubMed 作为搜索源。根据“苏格兰校际指南网络”，为每个结论分配了证据水平和推荐程度。
• 没有设计来回答 LHRH 类似物或激动剂之间类效应问题的研究。已经对许多其他与治疗管理相关的问题进行了综述和荟萃分析，无论是单独使用类似物，还是与放射治疗和手术联合使用。• 直接比较无法得出明确的结论。间接证据来自比较不同 LHRH 类似物与其他用于获得雄激素剥夺的治疗方法的随机研究。还评估了与药代动力学和药效学相关的其他问题，这些问题可以支持或不支持类效应的存在。
• 目前的证据不足以支持在不同的类似物在治疗前列腺癌的各种临床情况下，药物存在假定的类别效应。
