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Multicenter Study
. 2022 Nov;41(8):1824-1833.
doi: 10.1002/nau.25031. Epub 2022 Sep 7.

Effect of LHRH analogs on lower urinary tract symptoms associated with advanced prostate cancer in real clinical practice: ANALUTS study

Juan Morote  1 , Antonio Gómez-Caamaño  2 , Raúl Poza de Celis  3 , Francisco Gómez-Veiga  4 , Juan P Ciria  5 , Jesús Calleja  6 , Javier Extramiana  7 , Maria Pérez-Sampietro  8 , Valerie Perrot  9 , Javier C Angulo  10 ; ANALUTS Study Group
Affiliations
Multicenter Study

Effect of LHRH analogs on lower urinary tract symptoms associated with advanced prostate cancer in real clinical practice: ANALUTS study

Juan Morote et al. Neurourol Urodyn. 2022 Nov.

Abstract

Aims: To estimate the prevalence of lower urinary tract symptoms (LUTS) in patients with prostate cancer scheduled to receive LHRH analogs, and to assess the effectiveness of LHRH analogs on LUTS in patients presenting moderate/severe symptoms.

Methods: Prospective, noninterventional, multicenter study conducted at 28 centers in Spain and Portugal. LUTS were evaluated using the International Prostate Symptom Score (IPSS) at baseline, 24 and 48 weeks after initiation of treatment. Subanalyses were performed according to age and concomitant treatment (radiotherapy, alpha-blockers, and antiandrogens).

Results: A total of 354 patients were treated with LHRH analogs for 48 weeks. The percentage of patients with moderate/severe LUTS (IPSS > 7) decreased from 60.2% (n = 213/354) at baseline to 52.8% (n = 187/354) at Week 48. Among patients with moderate/severe LUTS at baseline: 73.7% (n = 157/213) still had moderate/severe LUTS at Week 48; percentage reductions of patients with LUTS at Week 48 were statistically significant (p < 0.05) overall and by age or concomitant treatment, except for alpha-blockers (84.2% patients receiving them still had moderate/severe LUTS at Week 48). All IPSS items, including quality of life for urinary symptoms, improved throughout the study. The only predictor of response to treatment with LHRH analogs that improved IPSS by 3 points after 48 weeks was baseline testosterone levels. Lower baseline testosterone levels were associated with greater improvement in IPSS after treatment with LHRH analogs (odds ratio 0.998, 95% confidence interval 0.996-1.000, p = 0.0277).

Conclusion: LHRH analogs have a positive effect in patients with locally advanced or metastatic prostate cancer presenting moderate/severe LUTS regardless of age or concomitant treatment received (radiotherapy, antiandrogens, or alpha-blockers).

Keywords: androgen deprivation; concomitant; hormonal therapy; quality of life; radiotherapy.

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Conflict of interest statement

Juan Morote, Antonio Gómez‐Caamaño, Raúl Poza de Celis, Francisco Gómez‐Veiga, Juan Pablo Ciria, Jesús Calleja, Javier Extramiana and Javier C. Angulo have no disclosure. Maria Pérez‐Sampietro and Valerie Perrot are employees of Ipsen Pharma.

Figures

Figure 1
Figure 1
Patient disposition in the study. IPSS, International Prostate Symptom Score; LHRH, luteinizing hormone‐releasing hormone; LUTS, lower urinary tract symptoms
Figure 2
Figure 2
Changes in IPSS and QoL during the study: (A) Evolution of patients with moderate/severe LUTS (IPSS > 7) after 48 weeks of treatment with LHRH analogs in the overall effectiveness population (n = 354) and in the population of patients with moderate/severe LUTS at baseline (n = 213); (B) Distribution of IPSS QoL categories after 48 weeks of treatment with LHRH analogs in the overall effectiveness population (n = 354) and in the population with moderate/severe LUTS at baseline (n = 213). (C) Proportion of patients with mild, moderate, and severe LUTS during the study in overall effectiveness population (n = 354); (D) Proportion of patients with mild, moderate and severe LUTS during the study in the effectiveness population with moderate to severe LUTS at baseline (n = 213). IPSS, International Prostate Symptom Score; LHRH, luteinizing hormone‐releasing hormone; LUTS, lower urinary tract symptoms; QoL, quality of life. *IPSS assessment at 48 weeks is at last available visit. For the vast majority of the patient (324/354) it is at 48 weeks but for the 30 remaining patients, it is at 24 weeks.
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References

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