666 CROSS SECTIONAL STUDY OF 1160 MEN TREATED BY GNRH AGONISTS – THE PRAGMA STUDY (2010)

You have accessJournal of UrologyProstate Cancer: Advanced II1 Apr 2010666 CROSS SECTIONAL STUDY OF 1160 MEN TREATED BY GNRH AGONISTS – THE PRAGMA STUDY Bernard Malavaud Bernard MalavaudBernard Malavaud More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1053AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES GnRH agonists are central to the treatment of locally advanced and metastatic prostate cancer. We took advantage of an industry-sponsored study to assess the conditions of their use in an unselected set of 1160 patients. METHODS Medical and personal histories were reviewed with special emphasis on life conditions (marital status, education level, car ownership), associated morbidities, supportive treatments (VitD, calcium, bisphosphonates, analgesics). Medical management was addressed through the estimation of the Karnofsky status and estimated life expectancy by the referring urologist and by the number of family doctor visits in the last year. RESULTS Mean age was 74.3±14.5 years confirming that GnRHa are mainly prescribed in the senior citizen, the mean duration of the treatment was 3.52±12.5 years. While mean BMI did not suggest morbid overweight (26.4±5.04), a significant majority still suffered from overweight (BMI 25-29.9: 50.8%) or obesity (>30: 13.2%) but no relationship could be drawn between BMI (in classes) and duration of GnRH treatment. Estimated life expectancy (ELE) was less than 5 years in 23,2%, between 5 and 10 years in 52.8% and longer that 10 years in 24%. Such ELE was strongly related to the Karnofsy status (77.8, 89.8 and 97.4% mean KS in patients with ELE <5, 5-10 and >10 years, respectively, p<0.00001), last PSA (24.9, 6.2 and 3.6 ng/ml, in patients with ELE <5, 5-10 and >10 years respectively, p=0.001), the marital status (p=0.02) and the level of education (lower ELE in patients with primary school only level of education). Diabetes was the most prevalent comobidity (23%) and related to BMI (P<0.0001) and duration of GnRH treatment (p=0.05). Intriguingly in view of the current EAU-AUA recommendations regarding bone loss prevention in androgen suppression, only a minority of patients were given adjunctive VitD (3.7%), Calcium (2.9%) and Bisphosphonates (6.2%), those drugs being more often prescribed in patients with higher level of education. 7.7% of the patients received painkillers. Family doctors were much involved in the follow-up as shown by a mean annual number of visits of 6.06. CONCLUSIONS This cross-sectional study provides an unbiased overview on the routine prescription of GnRH. In complement to objective factors such as medical and cancer history, individual and social backgrounds also play a part in this treatment. Toulouse, France© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e260-e261 Peer Review Report Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bernard Malavaud More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...