Prevalence study of intermittent hormonal therapy of Prostate Cancer patients in Spain

Xavier Bonfill-Cosp; Ariadna Auladell-Rispau; Ignasi Gich; Javier Zamora; Luis Carlos Saiz; Iratxe Urreta-Barallobre; José Antonio Cordero

doi:10.12688/f1000research.53875.2

Prevalence study of intermittent hormonal therapy of Prostate Cancer patients in Spain

Xavier Bonfill-Cosp, Ariadna Auladell-Rispau, Ignasi Gich, Javier Zamora, Luis Carlos Saiz, Iratxe Urreta-Barallobre, José Antonio Cordero^*

^*Corresponding author for this work

Metabolism and Systems Science

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: Although intermittent androgen deprivation therapy was introduced many years ago to improve patients' quality of life with the same carcinologic efficiency as continuous hormonal therapy, recent data suggest that intermittency could be underutilised. This study aims to estimate the prevalence of prostate cancer patients receiving intermittent androgen deprivation therapy in Spain.

Methods: A retrospective, longitudinal study was conducted using electronic drug dispensation data from four Spanish autonomous communities, which encompass 17.23 million inhabitants (36.22% of the total population in Spain). We estimated intermittent androgen therapy use (%IAD) and the prevalence of patients under intermittent androgen therapy in reference to the total number of PC patients using hormonal therapy (P IAD) and stratified by region. Other outcome variables included the pharmaceutical forms dispensed and the total direct annual expenditure on androgen deprivation therapy-associated medications.

Results: A total of 863,005 dispensations corresponding to a total of 65,752 men were identified, treated with either luteinizing hormone-releasing hormone (LHRH) analogues (353,162) administered alone or in combination with anti-androgens (509,843). Overall, the mean (±SD) age of the patients was 76.9 (±10.4) years. Results revealed that the mean annual P IAD along the study was 6.6% in the total population studied, and the overall %IAD during the five-year study period was 5.6%. The mean cost of hormonal therapy per year was 25 million euros for LHRH analogues and 6.3 million euros for anti-androgens.

Conclusions: Few prostate cancer patients in Spain use the intermittent androgen deprivation therapy suggesting underutilization of a perfectly valid option for a significant proportion of patients, missing the opportunity to improve their quality of life and to reduce costs for the National Health Service with comparable overall survival rates than continuous therapy.

Original language	English
Article number	1069
Number of pages	16
Journal	F1000Research
Volume	10
DOIs	https://doi.org/10.12688/f1000research.53875.2
Publication status	Published - 21 Apr 2022

Bibliographical note

Funding Information:
We are grateful to those who facilitated the data for this study: Public Data Analysis Program for Research and Innovation in Healthcare in Catalonia held by the Health Quality and Assessment Agency (AQuAS, Catalonia), Carmen Marina Meseguer Barros (Pharmaceutical Information Systems Area, Madrid Health Service), Javier Gorricho Mendívil (Planning, Evaluation and Management Service, Pamplona) and Begoña San Jose Ruiz (Hospital Pharmacy Department, Hospital de Cruces, Bilbao).

Publisher Copyright:
© 2022 Bonfill-Cosp X et al.

Keywords

Appropriateness
Intermittent androgen deprivation therapy (IAD)
LHRH analogues
Prostate cancer

ASJC Scopus subject areas

General Biochemistry,Genetics and Molecular Biology
General Immunology and Microbiology
Pharmacology, Toxicology and Pharmaceutics(all)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

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title = "Prevalence study of intermittent hormonal therapy of Prostate Cancer patients in Spain",

abstract = "Background: Although intermittent androgen deprivation therapy was introduced many years ago to improve patients' quality of life with the same carcinologic efficiency as continuous hormonal therapy, recent data suggest that intermittency could be underutilised. This study aims to estimate the prevalence of prostate cancer patients receiving intermittent androgen deprivation therapy in Spain. Methods: A retrospective, longitudinal study was conducted using electronic drug dispensation data from four Spanish autonomous communities, which encompass 17.23 million inhabitants (36.22% of the total population in Spain). We estimated intermittent androgen therapy use (%IAD) and the prevalence of patients under intermittent androgen therapy in reference to the total number of PC patients using hormonal therapy (P IAD) and stratified by region. Other outcome variables included the pharmaceutical forms dispensed and the total direct annual expenditure on androgen deprivation therapy-associated medications. Results: A total of 863,005 dispensations corresponding to a total of 65,752 men were identified, treated with either luteinizing hormone-releasing hormone (LHRH) analogues (353,162) administered alone or in combination with anti-androgens (509,843). Overall, the mean (±SD) age of the patients was 76.9 (±10.4) years. Results revealed that the mean annual P IAD along the study was 6.6% in the total population studied, and the overall %IAD during the five-year study period was 5.6%. The mean cost of hormonal therapy per year was 25 million euros for LHRH analogues and 6.3 million euros for anti-androgens. Conclusions: Few prostate cancer patients in Spain use the intermittent androgen deprivation therapy suggesting underutilization of a perfectly valid option for a significant proportion of patients, missing the opportunity to improve their quality of life and to reduce costs for the National Health Service with comparable overall survival rates than continuous therapy.",

keywords = "Appropriateness, Intermittent androgen deprivation therapy (IAD), LHRH analogues, Prostate cancer",

author = "Xavier Bonfill-Cosp and Ariadna Auladell-Rispau and Ignasi Gich and Javier Zamora and Saiz, {Luis Carlos} and Iratxe Urreta-Barallobre and Cordero, {Jos{\'e} Antonio}",

note = "Funding Information: We are grateful to those who facilitated the data for this study: Public Data Analysis Program for Research and Innovation in Healthcare in Catalonia held by the Health Quality and Assessment Agency (AQuAS, Catalonia), Carmen Marina Meseguer Barros (Pharmaceutical Information Systems Area, Madrid Health Service), Javier Gorricho Mend{\'i}vil (Planning, Evaluation and Management Service, Pamplona) and Bego{\~n}a San Jose Ruiz (Hospital Pharmacy Department, Hospital de Cruces, Bilbao). Publisher Copyright: {\textcopyright} 2022 Bonfill-Cosp X et al.",

year = "2022",

month = apr,

day = "21",

doi = "10.12688/f1000research.53875.2",

language = "English",

volume = "10",

journal = "F1000Research",

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T1 - Prevalence study of intermittent hormonal therapy of Prostate Cancer patients in Spain

AU - Bonfill-Cosp, Xavier

AU - Auladell-Rispau, Ariadna

AU - Gich, Ignasi

AU - Zamora, Javier

AU - Saiz, Luis Carlos

AU - Urreta-Barallobre, Iratxe

AU - Cordero, José Antonio

N1 - Funding Information: We are grateful to those who facilitated the data for this study: Public Data Analysis Program for Research and Innovation in Healthcare in Catalonia held by the Health Quality and Assessment Agency (AQuAS, Catalonia), Carmen Marina Meseguer Barros (Pharmaceutical Information Systems Area, Madrid Health Service), Javier Gorricho Mendívil (Planning, Evaluation and Management Service, Pamplona) and Begoña San Jose Ruiz (Hospital Pharmacy Department, Hospital de Cruces, Bilbao). Publisher Copyright: © 2022 Bonfill-Cosp X et al.

PY - 2022/4/21

Y1 - 2022/4/21

N2 - Background: Although intermittent androgen deprivation therapy was introduced many years ago to improve patients' quality of life with the same carcinologic efficiency as continuous hormonal therapy, recent data suggest that intermittency could be underutilised. This study aims to estimate the prevalence of prostate cancer patients receiving intermittent androgen deprivation therapy in Spain. Methods: A retrospective, longitudinal study was conducted using electronic drug dispensation data from four Spanish autonomous communities, which encompass 17.23 million inhabitants (36.22% of the total population in Spain). We estimated intermittent androgen therapy use (%IAD) and the prevalence of patients under intermittent androgen therapy in reference to the total number of PC patients using hormonal therapy (P IAD) and stratified by region. Other outcome variables included the pharmaceutical forms dispensed and the total direct annual expenditure on androgen deprivation therapy-associated medications. Results: A total of 863,005 dispensations corresponding to a total of 65,752 men were identified, treated with either luteinizing hormone-releasing hormone (LHRH) analogues (353,162) administered alone or in combination with anti-androgens (509,843). Overall, the mean (±SD) age of the patients was 76.9 (±10.4) years. Results revealed that the mean annual P IAD along the study was 6.6% in the total population studied, and the overall %IAD during the five-year study period was 5.6%. The mean cost of hormonal therapy per year was 25 million euros for LHRH analogues and 6.3 million euros for anti-androgens. Conclusions: Few prostate cancer patients in Spain use the intermittent androgen deprivation therapy suggesting underutilization of a perfectly valid option for a significant proportion of patients, missing the opportunity to improve their quality of life and to reduce costs for the National Health Service with comparable overall survival rates than continuous therapy.

AB - Background: Although intermittent androgen deprivation therapy was introduced many years ago to improve patients' quality of life with the same carcinologic efficiency as continuous hormonal therapy, recent data suggest that intermittency could be underutilised. This study aims to estimate the prevalence of prostate cancer patients receiving intermittent androgen deprivation therapy in Spain. Methods: A retrospective, longitudinal study was conducted using electronic drug dispensation data from four Spanish autonomous communities, which encompass 17.23 million inhabitants (36.22% of the total population in Spain). We estimated intermittent androgen therapy use (%IAD) and the prevalence of patients under intermittent androgen therapy in reference to the total number of PC patients using hormonal therapy (P IAD) and stratified by region. Other outcome variables included the pharmaceutical forms dispensed and the total direct annual expenditure on androgen deprivation therapy-associated medications. Results: A total of 863,005 dispensations corresponding to a total of 65,752 men were identified, treated with either luteinizing hormone-releasing hormone (LHRH) analogues (353,162) administered alone or in combination with anti-androgens (509,843). Overall, the mean (±SD) age of the patients was 76.9 (±10.4) years. Results revealed that the mean annual P IAD along the study was 6.6% in the total population studied, and the overall %IAD during the five-year study period was 5.6%. The mean cost of hormonal therapy per year was 25 million euros for LHRH analogues and 6.3 million euros for anti-androgens. Conclusions: Few prostate cancer patients in Spain use the intermittent androgen deprivation therapy suggesting underutilization of a perfectly valid option for a significant proportion of patients, missing the opportunity to improve their quality of life and to reduce costs for the National Health Service with comparable overall survival rates than continuous therapy.

KW - Appropriateness

KW - Intermittent androgen deprivation therapy (IAD)

KW - LHRH analogues

KW - Prostate cancer

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Prevalence study of intermittent hormonal therapy of Prostate Cancer patients in Spain

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

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