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Six-Month Formulation of Leuprolide Acetate Now Available
"The recent FDA approval of a six-month dosage form of Eligard 45mg is significant news for advanced prostate cancer patients and their physicians. Eligard effectively lowers testosterone and prostate-specific antigen (PSA) levels, thus providing patients with the added convenience of needing only two injections per year," said Oliver Sartor, M.D., Director of the Stanley Scott Cancer Center and Chief of the Hematology/Oncology Section at the Louisiana State University Health Sciences Center. "This new formulation will be of interest to those physicians who treat advanced prostate cancer patients by providing them with a new option to tailor the management of this condition to their patients' lifestyles."
Eligard 45 mg, a luteinizing hormone-releasing hormone (LHRH) agonist, is injected under the skin (subcutaneously) with a small-gauge needle. Once injected, it forms a solid bead that slowly releases Eligard's active substance, leuprolide acetate, over the course of six months. With the six-month formulation physicians and patients now have the flexibility to choose a more convenient formulation. "Patients who can benefit from the six-month formulation of Eligard include those who express a desire for fewer injections, travel a great deal or may be away from home for long periods, patients with restrictive work schedules, and those who live far from their physician's office or have transportation difficulties," said Oliver Sartor, M.D., Director of the Stanley Scott Cancer Center and chief of the Hematology/Oncology Section at Louisiana State University Health Sciences Center. "Although this formulation offers physicians and patients greater convenience, it is still important for patients to see their physicians on a regular basis for overall management of advanced prostate cancer."
About the Clinical Trial
The FDA approval was based on data from an open-label, multicenter clinical trial involving 111 advanced prostate cancer patients. Eligard 45 mg was administered once every six months as monotherapy for 12 months. Five of the patients in the clinical trial had stage A disease, 43 had stage B, 19 had stage C, and 44 had stage D. Two patients withdrew by Day 29.
The efficacy of Eligard 45 mg was measured by its ability to achieve and maintain castrate serum testosterone suppression over the 12-month study period. Serum testosterone was suppressed to below castrate threshold (less than or equal to 50 ng/dL) by Day 28 in 108 of the 109 (99.1 percent) patients.
A total of 106 patients enrolled in the clinical study received both injections of Eligard 45 mg. Once castrate suppression was achieved, only one patient experienced an increase or breakthrough of serum testosterone (>50 ng/dL) during the study. All five nonevaluable patients who achieved castration by Day 28 of the study maintained castration until withdrawing from the study. One hundred and three of the 111 patients initially enrolled completed the clinical trial.
The most frequently reported adverse events were hot flashes, fatigue, testicular atrophy, and transient (lasting for one minute or less) burning/stinging at the injection site. The majority (70%) of the hot flashes were mild.
Eligard should not be used by women, children, or anyone who is allergic to the drug leuprolide acetate or any of the ingredients of Eligard. Like other LHRH agonists, Eligard causes a transient increase in serum concentrations of testosterone during the first two weeks of treatment. Patients may experience worsening of existing symptoms or new symptoms in the first few weeks of treatment including bone pain, nerve damage, blood in the urine, or difficulty urinating. However, within 2 to 4 weeks patients experience a reduction of blood serum testosterone levels.
Eligard 45 mg uses the Atrigel drug delivery system to provide continuous release of leuprolide acetate over the six-month treatment period. The ATRIGEL drug delivery system consists of a biodegradable polymer mixed with the active drug just prior to administration. The mixture is injected just under the skin as a viscous liquid. The liquid quickly solidifies into a bead of medication that slowly dissolves to release a continuous supply of leuprolide acetate for the six-month period.
The sanofi-aventis Group currently markets several formulations of the LHRH agonist in the U.S. including Eligard one-month (7.5 mg), three-month (22.5 mg), and four-month (30 mg) extended-release products. This family of products will continue to be available for the palliative treatment of advanced prostate cancer.
Full prescribing information, including clinical trial information, safety, dosing, drug-drug interactions, and contraindications, is available by calling sanofi-aventis Product Information at 1-800-446-6267.
Prostate cancer is the most common cancer (excluding skin cancer) of American men. It's estimated that about 231,000 new cases of prostate cancer will be diagnosed in the United States, and 30,000 men will die of this disease this year. Moreover, prostate cancer is more common among African American men than white men, and African American men are more than twice as likely to die from the disease.
The chance of developing prostate cancer increases as a man ages. Men over the age of 65 make up more than 70 percent of new prostate cancer cases. Because prostate tumors differ greatly in their stage at diagnosis, degree of aggressiveness, rate of progression, and impact on men's lives, no single treatment plan fits all men diagnosed with prostate cancer.
Source: sanofi-aventis Group