前列腺癌中雄激素剥夺治疗（ADT）的持续性和依从性研究：美国的relugolix、degarelix和促性腺激素释放激素（GnRH）激动剂

Study of persistence and adherence to ADT in prostate cancer: relugolix, degarelix, and GnRH agonists in the US.

作者信息

Hafron Jason, Hong Agnes, Ryan Michael J, Romdhani Hela, Kinkead Frédéric, Flanders Scott C, McKay Rana R

机构信息

Department of Urology, Michigan Institute of Urology, Troy, MI, USA.

Pfizer Inc, New York, NY, USA.

出版信息

Future Oncol. 2025 Apr;21(10):1219-1230. doi: 10.1080/14796694.2025.2480050. Epub 2025 Apr 6.

DOI:10.1080/14796694.2025.2480050

PMID:40189880

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11988238/

Abstract

AIMS

Androgen deprivation therapy (ADT) is standard for advanced prostate cancer. Relugolix, a gonadotropin-releasing hormone (GnRH) receptor antagonist, is the only oral ADT, with limited real-world data on therapy persistence and adherence. This retrospective study evaluates persistence and adherence of relugolix, degarelix, and GnRH agonists (leuprolide, goserelin, triptorelin, histrelin) using data from the IBM MarketScan Research Database (Jan 2017 - Dec 2022).

METHODS

The IBM MarketScan Research Database (1 January 2017 - 31 December 2022) was used for enrollment history and claims. ADT adherence was measured by the proportion of days covered (PDC) at 3, 6, and 12 months, calculated as days on ADT divided by period duration. Kaplan-Meier analysis assessed treatment persistence by measuring time to treatment discontinuation.

RESULTS

Relugolix had higher adherence (PDC ≥ 80%) at 12 months (60.8%) compared to degarelix (13.0%) and GnRH agonists (46.3%). Median time to discontinuation was also longer for relugolix (13.5 months) than degarelix (3.1 months) and GnRH agonists (8.8 months). Persistence and adherence rates were higher in metastatic prostate cancer.

CONCLUSIONS

Findings support relugolix use as an oral treatment due to its favorable persistence and long-term adherence profiles.

摘要

目的

雄激素剥夺疗法（ADT）是晚期前列腺癌的标准治疗方法。Relugolix是一种促性腺激素释放激素（GnRH）受体拮抗剂，是唯一的口服ADT药物，关于其治疗持续性和依从性的真实世界数据有限。这项回顾性研究使用IBM MarketScan研究数据库（2017年1月 - 2022年12月）的数据评估relugolix、degarelix和GnRH激动剂（亮丙瑞林、戈舍瑞林、曲普瑞林、组氨瑞林）的持续性和依从性。

方法

使用IBM MarketScan研究数据库（2017年1月1日 - 2022年12月31日）获取入组历史和理赔数据。ADT依从性通过3个月、6个月和12个月时的覆盖天数比例（PDC）来衡量，计算方法为ADT治疗天数除以时间段时长。Kaplan-Meier分析通过测量治疗中断时间来评估治疗持续性。

结果

与degarelix（13.0%）和GnRH激动剂（46.3%）相比，relugolix在12个月时的依从性（PDC≥80%）更高（60.8%）。relugolix的中位停药时间（13.5个月）也比degarelix（3.1个月）和GnRH激动剂（8.8个月）更长。转移性前列腺癌的持续性和依从率更高。