Retrospective Analysis of Patients With Prostate Cancer Initiating GnRH Agonists/Antagonists Therapy Using a German Claims Database: Epidemiological and Patient Outcomes
Objective: The objective of this study was to obtain real-world information on gonadotropin-releasing hormone agonist/antagonist (GnRHa) therapy in patients with advanced prostate cancer (PCa).Materials and methods: Anonymized, routine healthcare claims data from approx. 75 German statutory health i...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2018-11-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2018.00543/full |
| _version_ | 1819002488066408448 |
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| author | Marie C. Hupe Peter Hammerer Miriam Ketz Nils Kossack Christiane Colling Axel S. Merseburger |
| author_facet | Marie C. Hupe Peter Hammerer Miriam Ketz Nils Kossack Christiane Colling Axel S. Merseburger |
| author_sort | Marie C. Hupe |
| collection | DOAJ |
| description | Objective: The objective of this study was to obtain real-world information on gonadotropin-releasing hormone agonist/antagonist (GnRHa) therapy in patients with advanced prostate cancer (PCa).Materials and methods: Anonymized, routine healthcare claims data from approx. 75 German statutory health insurance funds from 2010–2015 (n = 4,205,227) were analyzed. Patients had an enrolment of 1 year before GnRHa, 1 index quarter of initial GnRHa prescription and ≥2 years of follow-up.Results: In total, 2,382 patients with PCa were eligible. The most frequent index therapy was leuprolide in 56.6%. The rank order of PCa comorbidity prevalence was consistent over time (% at index and 3-years of follow-up): hypertension (71.5; 85.0), hyperlipidemia (45.2; 60.8), cardiovascular disease (CVD) (35.7; 54.1), and diabetes (28.3; 36.2). Comparing pooled therapy classes (agonists, hybrids, and antagonist), no significant differences in the incidence of CVD or diabetes were observed. For hypertension, there was a significant increase for agonists (16.4%) compared to antagonists (6.9%, p = 0.022) and leuprolide hybrid group (11.6%, p = 0.006). During the follow-up period 23.9% of all PCa patients died. There were no significant differences concerning mortality rate and discontinuation rates between the cohorts. In total, 11.2% of all patients discontinued GnRHa after first prescription; the mean time to first switch to another GnRHa therapy was 100 days earlier for hybrids than for agonists (p = 0.016).Conclusion: This comparative retrospective analysis provides real-world information about healthcare characteristics and treatment patterns, highlighting the impact of different GnRHa on clinical outcomes for patients with advanced PCa in Germany. |
| first_indexed | 2024-12-20T23:05:54Z |
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| id | doaj.art-a73a8b46d5b5462ebb035ff25ae9b404 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-20T23:05:54Z |
| publishDate | 2018-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-a73a8b46d5b5462ebb035ff25ae9b4042022-12-21T19:23:51ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2018-11-01810.3389/fonc.2018.00543421750Retrospective Analysis of Patients With Prostate Cancer Initiating GnRH Agonists/Antagonists Therapy Using a German Claims Database: Epidemiological and Patient OutcomesMarie C. Hupe0Peter Hammerer1Miriam Ketz2Nils Kossack3Christiane Colling4Axel S. Merseburger5Department of Urology, University Hospital Schleswig-Holstein, Luebeck, GermanyDepartment of Urology, Academic Hospital Braunschweig, Brunswick, GermanyD-to-D Data to Decision AG, Hamburg, GermanyWIG2 GmbH—Scientific Institute for Health Economics and Health System Research, Leipzig, GermanyIpsen Pharma GmbH, Ettlingen, GermanyDepartment of Urology, University Hospital Schleswig-Holstein, Luebeck, GermanyObjective: The objective of this study was to obtain real-world information on gonadotropin-releasing hormone agonist/antagonist (GnRHa) therapy in patients with advanced prostate cancer (PCa).Materials and methods: Anonymized, routine healthcare claims data from approx. 75 German statutory health insurance funds from 2010–2015 (n = 4,205,227) were analyzed. Patients had an enrolment of 1 year before GnRHa, 1 index quarter of initial GnRHa prescription and ≥2 years of follow-up.Results: In total, 2,382 patients with PCa were eligible. The most frequent index therapy was leuprolide in 56.6%. The rank order of PCa comorbidity prevalence was consistent over time (% at index and 3-years of follow-up): hypertension (71.5; 85.0), hyperlipidemia (45.2; 60.8), cardiovascular disease (CVD) (35.7; 54.1), and diabetes (28.3; 36.2). Comparing pooled therapy classes (agonists, hybrids, and antagonist), no significant differences in the incidence of CVD or diabetes were observed. For hypertension, there was a significant increase for agonists (16.4%) compared to antagonists (6.9%, p = 0.022) and leuprolide hybrid group (11.6%, p = 0.006). During the follow-up period 23.9% of all PCa patients died. There were no significant differences concerning mortality rate and discontinuation rates between the cohorts. In total, 11.2% of all patients discontinued GnRHa after first prescription; the mean time to first switch to another GnRHa therapy was 100 days earlier for hybrids than for agonists (p = 0.016).Conclusion: This comparative retrospective analysis provides real-world information about healthcare characteristics and treatment patterns, highlighting the impact of different GnRHa on clinical outcomes for patients with advanced PCa in Germany.https://www.frontiersin.org/article/10.3389/fonc.2018.00543/fulladvanced prostate cancerretrospective health service researchGerman claims databaseGnRH agonistGnRH antagonistandrogen deprivation therapy |
| spellingShingle | Marie C. Hupe Peter Hammerer Miriam Ketz Nils Kossack Christiane Colling Axel S. Merseburger Retrospective Analysis of Patients With Prostate Cancer Initiating GnRH Agonists/Antagonists Therapy Using a German Claims Database: Epidemiological and Patient Outcomes Frontiers in Oncology advanced prostate cancer retrospective health service research German claims database GnRH agonist GnRH antagonist androgen deprivation therapy |
| title | Retrospective Analysis of Patients With Prostate Cancer Initiating GnRH Agonists/Antagonists Therapy Using a German Claims Database: Epidemiological and Patient Outcomes |
| title_full | Retrospective Analysis of Patients With Prostate Cancer Initiating GnRH Agonists/Antagonists Therapy Using a German Claims Database: Epidemiological and Patient Outcomes |
| title_fullStr | Retrospective Analysis of Patients With Prostate Cancer Initiating GnRH Agonists/Antagonists Therapy Using a German Claims Database: Epidemiological and Patient Outcomes |
| title_full_unstemmed | Retrospective Analysis of Patients With Prostate Cancer Initiating GnRH Agonists/Antagonists Therapy Using a German Claims Database: Epidemiological and Patient Outcomes |
| title_short | Retrospective Analysis of Patients With Prostate Cancer Initiating GnRH Agonists/Antagonists Therapy Using a German Claims Database: Epidemiological and Patient Outcomes |
| title_sort | retrospective analysis of patients with prostate cancer initiating gnrh agonists antagonists therapy using a german claims database epidemiological and patient outcomes |
| topic | advanced prostate cancer retrospective health service research German claims database GnRH agonist GnRH antagonist androgen deprivation therapy |
| url | https://www.frontiersin.org/article/10.3389/fonc.2018.00543/full |
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