Summary

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• This summary is based on the review of two systematic review(s)/meta-analysis(es). ^[1-2]
• The reviewed studies did not provide direct evidence on the clinical effectiveness of leuprolide acetate or other gonadotropin-releasing hormone (GnRH) agonists in prostate cancer treatment; instead, they focused on cardiovascular safety and rare adverse events, particularly comparing GnRH agonists to antagonists.
• Subgroup analyses were not detailed in terms of effectiveness outcomes. The only notable subgroup concern mentioned was an elevated risk of pituitary apoplexy in older prostate cancer patients with pre-existing pituitary adenomas following GnRH agonist administration.
• GnRH antagonists, such as degarelix and relugolix, presented a significantly lower risk of cardiovascular adverse events compared to GnRH agonists, with pooled risk ratios (OR) indicating reduced occurrences of adverse cardiovascular events (0.57; 95% confidence interval (CI): 0.39-0.81), cardiovascular death (0.49; 95% CI: 0.25-0.96), and all-cause mortality (0.48; 95% CI: 0.28-0.83).
• Pituitary apoplexy was identified as a rare but serious adverse event following GnRH agonist administration, particularly in prostate cancer patients with pre-existing pituitary adenomas. This condition manifested with symptoms such as headache (100%) and ophthalmoplegia (85.7%), with a median onset of 5 hours post-administration, and required surgical intervention in 71.4% of cases.
• There is no population types or subgroups information available in the reviewed studies.