Prostate Cancer
Conditions
Keywords
Relugolix
Brief summary
The purpose of this real-world study is the learn about the demographics and clinical characteristics of patients with prostate cancer who initiated relugolix
Detailed description
Prostate cancer (PC) is the most common cancer and the second leading cause of cancer death among men in the United States. Androgen deprivation therapy (ADT) such as injectable luteinizing hormone-releasing hormone (LHRH) agonists (e.g., leuprolide) is the standard of care for PC patients. ADT treatment can suppress testosterone level to castrate level and delay the progression of the disease. Relugolix is a recently approved oral GnRH antagonist. While the introduction of relugolix has offered a unique opportunity for patients with PC, it's vital to understand how it is being used in real-world.
Interventions
relugolix
Sponsors
Study design
Eligibility
Inclusion criteria
* Male with ≥ 1 diagnosis for PC * Had ≥ 2 prescriptions of relugolix on or after the first observed PC diagnosis. * Index date: the initiation date of relugolix * At least 18 years old at the index date
Exclusion criteria
* had surgical castration (bilateral orchiectomy) any time before the index date
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants According to Geographic Region | Baseline period = Up to 1 year prior to index date; available data observed retrospectively over 178 days in this study | The number of participants according to geographic regions of the United States (South, West, Northeast and Midwest) as documented during baseline period were reported in this outcome measure. Baseline period was 1 year prior to index date; index date was the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed prostate cancer diagnosis. |
| Number of Participants According to Index Year | At Index date (anytime between 18-Dec-2020 to 31-Dec- 2023 [approximately 3 years]; available data observed retrospectively over 178 days in this study | Number of participants according to index year (2020, 2021, 2022 and 2023) were reported in this outcome measure. The index date was defined as the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed prostate cancer diagnosis. |
| Time From First Observed Prostate Cancer Diagnosis Date to the Index Date | From prostate cancer diagnosis to index date (approximately maximum up to 18 years); available data observed retrospectively over 178 days in this study | Time from the first observed prostate cancer date to the index date was evaluated. All data available prior to the index date were used. The index date was defined as the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed prostate cancer diagnosis. Participants with a diagnosis of prostate cancer between 01-Jan-2006 to 31-Dec-2023 were considered. |
| Number of Participants According to Type of Previous Treatments Received | Baseline period = Up to 1 year prior to index date; available data observed retrospectively over 178 days in this study | Number of participants according to treatments received previously such as pain medication, androgen receptor pathway inhibitor, androgen deprivation therapy, chronic oral corticosteroid use, non-steroidal anti-androgen, radiotherapy, olaparib, prostatectomy and chemotherapy in the baseline period were reported in this outcome measure. Baseline period was 1 year prior to index date; index date was the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed prostate cancer diagnosis. One participant could have received more than 1 treatment. |
| Number of Participants According to Metastasis Status | Baseline period = Up to 1 year prior to index date or within 90 days after the index date; available data observed retrospectively over 178 days in this study | Number of participants according to metastasis status (metastatic prostate cancer and non-metastatic prostate cancer) were reported in this outcome measure. Metastatic prostate cancer was defined as having evidence of during the baseline period or within 90 days after the index date. Baseline period was 1 year prior to index date; index date was the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed prostate cancer diagnosis. |
| Number of Participants According to Site of Metastasis | Baseline period = Up to 1 year prior to index date or within 90 days after the index date; available data observed retrospectively over 178 days in this study | Number of participants with a metastatic diagnosis at the sites: bone only, node only, bone and node, viscera and other (urinary organs, genital organs, skin, kidney, adrenal, brain, spinal, and other nervous system), were reported among participants with metastatic prostate cancer. Metastatic prostate cancer was defined as having evidence of metastasis any time prior to the index date or within 90 days after the index date. Baseline period was 1 year prior to index date; index date was the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed prostate cancer diagnosis. |
| Number of Participants According to Androgen Deprivation Therapy (ADT) Status | Any time prior to index date including baseline period (approximately maximum up to 18 years); available data observed retrospectively over 178 days in this study | ADT naïve was defined as having no records of any systemic ADT ever based on all available data prior to the index date (i.e., including baseline period data and any available data prior to the baseline period). Systemic ADT included luteinizing hormone-releasing hormone (LHRH) agonists and gonadotropin-releasing hormone (GnRH) antagonists (i.e., degarelix, relugolix, goserelin, histrelin, leuprolide, triptorelin). ADT experienced was defined as having any records of systemic ADT based on all available data prior to the index date (i.e., including baseline period data and any available data prior to the baseline period). Baseline period was 1 year prior to index date; index date was the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed prostate cancer diagnosis. |
| Prostate-Specific Antigen (PSA) Value at 180 Days Prior to Index Date | 180 days prior to Index date; data observed retrospectively over 178 days in this study | The index date was defined as the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed PC diagnosis. |
| Testosterone Value at 180 Days Prior to Index Date | 180 days prior to Index date; data observed retrospectively over 178 days in this study | The index date was defined as the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed PC diagnosis. |
| Mean National Cancer Institute (NCI) Charlson Comorbidity Index (CCI) Score | Baseline period = Up to 1 year prior to index date or within 90 days after the index date; available data observed retrospectively over 178 days in this study | CCI based on various comorbid conditions such as myocardial infarction, congestive heart failure, peripheral vascular disease, cerebrovascular disease, dementia, chronic obstructive pulmonary disease, rheumatologic disease, peptic ulcer disease, mild liver disease, diabetes (mild to moderate), diabetes + complications, hemiplegia or paraplegia, renal disease, any malignancy (lymphoma and leukemia), moderate/severe liver disease, metastatic solid tumor, and acquired immune deficiency syndrome (AIDS) were reported. CCI score range was from 0 to 14, where 0= low comorbid condition and 14= high comorbid condition, higher scores indicated more comorbidity. Baseline period was 1 year prior to index date; index date was the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed prostate cancer diagnosis. |
| Number of Participants According to Comorbidities | Baseline period = Up to 1 year prior to index date or within 90 days after the index date; available data observed retrospectively over 178 days in this study | Number of participants according to comorbidities (hypertension, hyperlipidemia, diabetes, major adverse cardiovascular event, depression, congestive heart failure, sexual dysfunction, chronic obstructive pulmonary disease, anxiety, cognitive impairment, urinary tract infection, myocardial infarction, arrhythmia, stroke, acute coronary syndrome, angina pectoris, inflammatory bowel disease, hot flashes) were reported in this outcome measure. Baseline period was 1 year prior to index date; index date was the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed prostate cancer diagnosis. One participant could have more than one comorbidity. |
Countries
United States
Participant flow
Recruitment details
Data from participants with a diagnosis of prostate cancer between 01-Jan-2006 to 31-Dec-2023 and who had initiated relugolix anytime between 18-Dec-2020 (approval date for relugolix in the United States) to 31-Dec-2023 was included. Data was collected from the National Veterans Affairs (VA) Health Care Network database. Available retrospective data was evaluated over 178 days (from 19-Jun-2024 to 13-Dec-2024) in this observational study per its objective.
Participants by arm
| Arm | Count |
|---|---|
| Relugolix Participants who were diagnosed with prostate cancer and had initiated relugolix between 18-Dec-2020 to 31-Dec-2023 were observed. No intervention was administered in this study. | 507 |
| Total | 507 |
Baseline characteristics
| Characteristic | Relugolix |
|---|---|
| Age, Continuous | 74.2 Years STANDARD_DEVIATION 7.9 |
| Race/Ethnicity, Customized Black | 141 Participants |
| Race/Ethnicity, Customized Hispanic | 16 Participants |
| Race/Ethnicity, Customized Other | 6 Participants |
| Race/Ethnicity, Customized Unknown | 31 Participants |
| Race/Ethnicity, Customized White, non-Hispanic | 313 Participants |
| Sex: Female, Male Female | 0 Participants |
| Sex: Female, Male Male | 507 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 38 / 507 |
| other Total, other adverse events | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 |
Outcome results
Mean National Cancer Institute (NCI) Charlson Comorbidity Index (CCI) Score
CCI based on various comorbid conditions such as myocardial infarction, congestive heart failure, peripheral vascular disease, cerebrovascular disease, dementia, chronic obstructive pulmonary disease, rheumatologic disease, peptic ulcer disease, mild liver disease, diabetes (mild to moderate), diabetes + complications, hemiplegia or paraplegia, renal disease, any malignancy (lymphoma and leukemia), moderate/severe liver disease, metastatic solid tumor, and acquired immune deficiency syndrome (AIDS) were reported. CCI score range was from 0 to 14, where 0= low comorbid condition and 14= high comorbid condition, higher scores indicated more comorbidity. Baseline period was 1 year prior to index date; index date was the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed prostate cancer diagnosis.
Time frame: Baseline period = Up to 1 year prior to index date or within 90 days after the index date; available data observed retrospectively over 178 days in this study
Population: Analysis population included all eligible participants whose data was retrieved and observed in this retrospective observational study.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Relugolix | Mean National Cancer Institute (NCI) Charlson Comorbidity Index (CCI) Score | 1.8 Units on a scale | Standard Deviation 2.1 |
Number of Participants According to Androgen Deprivation Therapy (ADT) Status
ADT naïve was defined as having no records of any systemic ADT ever based on all available data prior to the index date (i.e., including baseline period data and any available data prior to the baseline period). Systemic ADT included luteinizing hormone-releasing hormone (LHRH) agonists and gonadotropin-releasing hormone (GnRH) antagonists (i.e., degarelix, relugolix, goserelin, histrelin, leuprolide, triptorelin). ADT experienced was defined as having any records of systemic ADT based on all available data prior to the index date (i.e., including baseline period data and any available data prior to the baseline period). Baseline period was 1 year prior to index date; index date was the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed prostate cancer diagnosis.
Time frame: Any time prior to index date including baseline period (approximately maximum up to 18 years); available data observed retrospectively over 178 days in this study
Population: Analysis population included all eligible participants whose data was retrieved and observed in this retrospective observational study. Here, Number Analyzed signifies number of participants evaluable for the specified rows.
| Arm | Measure | Group | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|---|
| Relugolix | Number of Participants According to Androgen Deprivation Therapy (ADT) Status | Metastatic PC | ADT naïve | 80 Participants |
| Relugolix | Number of Participants According to Androgen Deprivation Therapy (ADT) Status | Metastatic PC | ADT experienced | 89 Participants |
| Relugolix | Number of Participants According to Androgen Deprivation Therapy (ADT) Status | No known metastases | ADT naïve | 286 Participants |
| Relugolix | Number of Participants According to Androgen Deprivation Therapy (ADT) Status | No known metastases | ADT experienced | 52 Participants |
Number of Participants According to Comorbidities
Number of participants according to comorbidities (hypertension, hyperlipidemia, diabetes, major adverse cardiovascular event, depression, congestive heart failure, sexual dysfunction, chronic obstructive pulmonary disease, anxiety, cognitive impairment, urinary tract infection, myocardial infarction, arrhythmia, stroke, acute coronary syndrome, angina pectoris, inflammatory bowel disease, hot flashes) were reported in this outcome measure. Baseline period was 1 year prior to index date; index date was the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed prostate cancer diagnosis. One participant could have more than one comorbidity.
Time frame: Baseline period = Up to 1 year prior to index date or within 90 days after the index date; available data observed retrospectively over 178 days in this study
Population: Analysis population included all eligible participants whose data was retrieved and observed in this retrospective observational study.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Relugolix | Number of Participants According to Comorbidities | Hypertension | 357 Participants |
| Relugolix | Number of Participants According to Comorbidities | Hyperlipidemia | 319 Participants |
| Relugolix | Number of Participants According to Comorbidities | Diabetes | 168 Participants |
| Relugolix | Number of Participants According to Comorbidities | Major adverse cardiovascular event | 114 Participants |
| Relugolix | Number of Participants According to Comorbidities | Depression | 90 Participants |
| Relugolix | Number of Participants According to Comorbidities | Congestive heart failure | 74 Participants |
| Relugolix | Number of Participants According to Comorbidities | Sexual dysfunction | 74 Participants |
| Relugolix | Number of Participants According to Comorbidities | Chronic obstructive pulmonary disease | 68 Participants |
| Relugolix | Number of Participants According to Comorbidities | Anxiety | 57 Participants |
| Relugolix | Number of Participants According to Comorbidities | Cognitive impairment | 57 Participants |
| Relugolix | Number of Participants According to Comorbidities | Urinary tract infection | 52 Participants |
| Relugolix | Number of Participants According to Comorbidities | Myocardial infarction | 31 Participants |
| Relugolix | Number of Participants According to Comorbidities | Arrhythmia | 28 Participants |
| Relugolix | Number of Participants According to Comorbidities | Stroke | 26 Participants |
| Relugolix | Number of Participants According to Comorbidities | Acute coronary syndrome | 15 Participants |
| Relugolix | Number of Participants According to Comorbidities | Angina pectoris | 11 Participants |
| Relugolix | Number of Participants According to Comorbidities | Inflammatory bowel disease | 6 Participants |
| Relugolix | Number of Participants According to Comorbidities | Hot flashes | 2 Participants |
Number of Participants According to Geographic Region
The number of participants according to geographic regions of the United States (South, West, Northeast and Midwest) as documented during baseline period were reported in this outcome measure. Baseline period was 1 year prior to index date; index date was the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed prostate cancer diagnosis.
Time frame: Baseline period = Up to 1 year prior to index date; available data observed retrospectively over 178 days in this study
Population: Analysis population included all eligible participants whose data was retrieved and observed in this retrospective observational study.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Relugolix | Number of Participants According to Geographic Region | South | 240 Participants |
| Relugolix | Number of Participants According to Geographic Region | West | 94 Participants |
| Relugolix | Number of Participants According to Geographic Region | Northeast | 93 Participants |
| Relugolix | Number of Participants According to Geographic Region | Midwest | 80 Participants |
Number of Participants According to Index Year
Number of participants according to index year (2020, 2021, 2022 and 2023) were reported in this outcome measure. The index date was defined as the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed prostate cancer diagnosis.
Time frame: At Index date (anytime between 18-Dec-2020 to 31-Dec- 2023 [approximately 3 years]; available data observed retrospectively over 178 days in this study
Population: Analysis population included all eligible participants whose data was retrieved and observed in this retrospective observational study.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Relugolix | Number of Participants According to Index Year | 2020 | 0 Participants |
| Relugolix | Number of Participants According to Index Year | 2021 | 81 Participants |
| Relugolix | Number of Participants According to Index Year | 2022 | 203 Participants |
| Relugolix | Number of Participants According to Index Year | 2023 | 223 Participants |
Number of Participants According to Metastasis Status
Number of participants according to metastasis status (metastatic prostate cancer and non-metastatic prostate cancer) were reported in this outcome measure. Metastatic prostate cancer was defined as having evidence of during the baseline period or within 90 days after the index date. Baseline period was 1 year prior to index date; index date was the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed prostate cancer diagnosis.
Time frame: Baseline period = Up to 1 year prior to index date or within 90 days after the index date; available data observed retrospectively over 178 days in this study
Population: Analysis population included all eligible participants whose data was retrieved and observed in this retrospective observational study.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Relugolix | Number of Participants According to Metastasis Status | Metastatic prostate cancer | 169 Participants |
| Relugolix | Number of Participants According to Metastasis Status | Non-metastatic prostate cancer | 338 Participants |
Number of Participants According to Site of Metastasis
Number of participants with a metastatic diagnosis at the sites: bone only, node only, bone and node, viscera and other (urinary organs, genital organs, skin, kidney, adrenal, brain, spinal, and other nervous system), were reported among participants with metastatic prostate cancer. Metastatic prostate cancer was defined as having evidence of metastasis any time prior to the index date or within 90 days after the index date. Baseline period was 1 year prior to index date; index date was the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed prostate cancer diagnosis.
Time frame: Baseline period = Up to 1 year prior to index date or within 90 days after the index date; available data observed retrospectively over 178 days in this study
Population: Analysis population included all eligible participants whose data was retrieved and observed in this retrospective observational study. Here, Overall Number of Participants Analyzed signifies number of participants evaluable for this outcome measure.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Relugolix | Number of Participants According to Site of Metastasis | Bone only | 59 Participants |
| Relugolix | Number of Participants According to Site of Metastasis | Node only | 34 Participants |
| Relugolix | Number of Participants According to Site of Metastasis | Bone and Node | 20 Participants |
| Relugolix | Number of Participants According to Site of Metastasis | Viscera | 20 Participants |
| Relugolix | Number of Participants According to Site of Metastasis | Other | 36 Participants |
Number of Participants According to Type of Previous Treatments Received
Number of participants according to treatments received previously such as pain medication, androgen receptor pathway inhibitor, androgen deprivation therapy, chronic oral corticosteroid use, non-steroidal anti-androgen, radiotherapy, olaparib, prostatectomy and chemotherapy in the baseline period were reported in this outcome measure. Baseline period was 1 year prior to index date; index date was the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed prostate cancer diagnosis. One participant could have received more than 1 treatment.
Time frame: Baseline period = Up to 1 year prior to index date; available data observed retrospectively over 178 days in this study
Population: Analysis population included all eligible participants whose data was retrieved and observed in this retrospective observational study. All the participants of the study were analyzed but not all participants might have contributed to the data reported.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Relugolix | Number of Participants According to Type of Previous Treatments Received | Pain medication | 103 Participants |
| Relugolix | Number of Participants According to Type of Previous Treatments Received | Androgen receptor pathway inhibitor | 86 Participants |
| Relugolix | Number of Participants According to Type of Previous Treatments Received | Androgen deprivation therapy | 77 Participants |
| Relugolix | Number of Participants According to Type of Previous Treatments Received | Chronic oral corticosteroid use | 48 Participants |
| Relugolix | Number of Participants According to Type of Previous Treatments Received | Non-steroidal anti-androgen | 46 Participants |
| Relugolix | Number of Participants According to Type of Previous Treatments Received | Radiotherapy | 7 Participants |
| Relugolix | Number of Participants According to Type of Previous Treatments Received | Olaparib | 3 Participants |
| Relugolix | Number of Participants According to Type of Previous Treatments Received | Prostatectomy | 3 Participants |
| Relugolix | Number of Participants According to Type of Previous Treatments Received | Chemotherapy | 2 Participants |
Prostate-Specific Antigen (PSA) Value at 180 Days Prior to Index Date
The index date was defined as the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed PC diagnosis.
Time frame: 180 days prior to Index date; data observed retrospectively over 178 days in this study
Population: Analysis population included all eligible participants whose data was retrieved and observed in this retrospective observational study. Here, 'Overall Number of Participants Analyzed' signifies number of participants evaluable for this outcome measure.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Relugolix | Prostate-Specific Antigen (PSA) Value at 180 Days Prior to Index Date | 118.8 Nanograms per milliliter | Standard Deviation 1080.6 |
Testosterone Value at 180 Days Prior to Index Date
The index date was defined as the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed PC diagnosis.
Time frame: 180 days prior to Index date; data observed retrospectively over 178 days in this study
Population: Analysis population included all eligible participants whose data was retrieved and observed in this retrospective observational study. Here, 'Overall Number of Participants Analyzed' signifies number of participants evaluable for this outcome measure.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Relugolix | Testosterone Value at 180 Days Prior to Index Date | 200.9 Nanograms per deciliter | Standard Deviation 213.1 |
Time From First Observed Prostate Cancer Diagnosis Date to the Index Date
Time from the first observed prostate cancer date to the index date was evaluated. All data available prior to the index date were used. The index date was defined as the initiation date of relugolix (anytime between 18-Dec-2020 to 31-Dec-2023) on or after the first observed prostate cancer diagnosis. Participants with a diagnosis of prostate cancer between 01-Jan-2006 to 31-Dec-2023 were considered.
Time frame: From prostate cancer diagnosis to index date (approximately maximum up to 18 years); available data observed retrospectively over 178 days in this study
Population: Analysis population included all eligible participants whose data was retrieved and observed in this retrospective observational study.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Relugolix | Time From First Observed Prostate Cancer Diagnosis Date to the Index Date | 55.8 Months | Standard Deviation 61.7 |