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Meta-Analysis
. 2016 Jul;95(27):e3845.
doi: 10.1097/MD.0000000000003845.

A meta-analysis and systematic review of randomized controlled trials with degarelix versus gonadotropin-releasing hormone agonists for advanced prostate cancer

Alessandro Sciarra  1 , Andrea Fasulo, Antonio Ciardi, Elisa Petrangeli, Alessandro Gentilucci, Martina Maggi, Michele Innocenzi, Federico Pierella, Vincenzo Gentile, Stefano Salciccia, Susanna Cattarino
Affiliations
Meta-Analysis

A meta-analysis and systematic review of randomized controlled trials with degarelix versus gonadotropin-releasing hormone agonists for advanced prostate cancer

Alessandro Sciarra et al. Medicine (Baltimore). 2016 Jul.

Erratum in

Abstract

Our aim was to systematically evaluate the benefits of degarelix as antagonist versus agonists of gonadotropin-releasing hormones (GnRH) for the treatment of advanced prostate cancer (PC). This comparison was performed either in terms of biochemical or oncological or safety profiles. To this end we, carried out a systematic review and meta-analysis of the literature.We selected only studies directly and prospectively analyzing the two treatments in the same population (randomized phase III studies). We followed the Preferred Reporting Items for Systematic Reviews and meta-analyses process for reporting studies.After we eliminated studies according to the exclusion criteria, 9 publications were considered relevant to this review. These articles described 5 clinical trials that were eligible for inclusion. The follow-up duration in all trials did not exceed 364 days. This meta-analysis and review comprised a total of 1719 men, 1061 randomized to degarelix versus 658 to GnRH agonists treatment for advanced PC. Oncological results were evaluated only in 1 trial (CS21:408 cases) and they were not the primary endpoints of the study. Treatment emerging adverse events were reported in 61.4% and 58.8% of patients in the degarelix and GnRH agonists group, respectively (odds ratio, OR = 1.17; 95% confidence interval, 95% CI: 0.78-1.77, P > 0.1). Treatment related severe cardiovascular side effects were reported (trial CS21-30-35) in 1.6% and 3.6% of patients in the degarelix and GnRH agonists group, respectively (OR = 0.55, 95% CI: 0.26-1.14, P > 0.1).Our analysis evidences relevant limitations in particular for the comparative evaluation of the efficacy and the oncological results related to degarelix.

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Conflict of interest statement

There are no conflicts of interest for all authors, related to this meta-analysis study.

Figures

Figure 1
Figure 1
flow-chart showing the numbers of papers identified and included or excluded at each stage of our analysis.
Figure 2
Figure 2
Meta-analysis of PSA variation comparing degarelix versus GnRH agonist therapy groups.
Figure 3
Figure 3
Meta-analysis of emerging adverse events comparing degarelix versus GnRH agonist therapy groups.
Figure 4
Figure 4
Meta-analysis of dropout from the study due to adverse events comparing degarelix versus GnRH agonists therapy groups.
Figure 5
Figure 5
differences in the incidence of the most common treatment related adverse events.
Figure 6
Figure 6
Meta-analysis of adverse event flushing comparing degarelix versus GnRH agonist therapy groups.
Figure 7
Figure 7
Meta-analysis of injection-site reaction adverse event comparing degarelix versus GnRH agonist therapy groups.
Figure 8
Figure 8
Meta-analysis of severe cardiovascular side effect comparing degarelix versus GnRH agonist therapy groups.
Figure 9
Figure 9
Meta-analysis of LUTS variation comparing degarelix versus GnRH agonist therapy groups.
Figure 10
Figure 10
Meta-analysis of prostate volume reduction comparing degarelix versus GnRH agonist therapy groups.
See this image and copyright information in PMC

References

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