Luteinizing hormone--releasing hormone agonists: a quick reference for prevalence rates of potential adverse effects

Clin Genitourin Cancer. 2013 Dec;11(4):375-84. doi: 10.1016/j.clgc.2013.05.004. Epub 2013 Jul 25.

Abstract

Men with prostate cancer (PCa) frequently undergo androgen deprivation therapy (ADT), typically in the form of a depot injection of luteinizing hormone-releasing hormone agonists (LHRHa). LHRHa are associated with many adverse effects (eg, hot flashes, sexual dysfunction, loss of muscle mass, osteopenia, metabolic syndrome), which drastically impact patient quality of life. This literature review, which includes a comprehensive table documenting prevalence rates, provides a quick reference for health care professionals involved in the care of men undergoing ADT with LHRHa. Primary sources were acquired from PubMed using the search terms "androgen deprivation therapy" and each potentially adverse effect (eg, "androgen deprivation therapy and hot flashes"). Commonly cited review articles were also examined for citations of original studies containing prevalence rates. More than 270 articles were reviewed. In contrast to many existing reviews, rates are cited exclusively from original sources. The prevalence rates, obtained from original sources, suggest that more than half of documented adverse effects are experienced by as many as 40% or more of patients. A critique of the literature is also provided. Although there is a vast literature of both original and review articles on specific adverse effects of LHRHa, the quality of research on prevalence rates for some adverse effects is subpar. Many review articles contain inaccuracies and do not cite original sources. The table of prevalence rates will serve as a quick reference for health care providers when counseling patients and will aid in the development of evidence-based patient education materials.

Keywords: Androgen deprivation therapy; Continuing medical education; LHRH agonist; Prostate cancer; Side effect.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Androgen Antagonists / adverse effects*
  • Androgen Antagonists / therapeutic use*
  • Antineoplastic Agents, Hormonal / adverse effects
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Diethylstilbestrol / adverse effects
  • Diethylstilbestrol / therapeutic use
  • Drug-Related Side Effects and Adverse Reactions
  • Estrogens / adverse effects
  • Estrogens / therapeutic use
  • Gonadotropin-Releasing Hormone / agonists*
  • Humans
  • Male
  • Prostatic Neoplasms / drug therapy*
  • Prostatic Neoplasms / mortality
  • Quality of Life
  • Survival
  • Treatment Outcome

Substances

  • Androgen Antagonists
  • Antineoplastic Agents, Hormonal
  • Estrogens
  • Gonadotropin-Releasing Hormone
  • Diethylstilbestrol