title: Quality of life improvement in patients treated with degarelix versus leuprorelin for advanced prostate cancer.
abstract: OBJECTIVE
  We used responses to questionnaires included in the CS21 degarelix trial and published mapping algorithms to address the paucity of evidence for health related quality of life in patients with advanced hormone dependent prostate cancer treated with degarelix.
  
  
  METHODS
  We measured health related quality of life in 610 patients enrolled in the CS21 trial using SF-12® and EORTC QLQ-C30. Based on responses to these questionnaires we estimated patient utility using 4 published mapping algorithms. Utility was tested for relationships with aspects of the symptom and side effect burden that may be affected by degarelix treatment, that is prostate specific antigen progression and adverse events.
  
  
  RESULTS
  Average utility in patients without prostate specific antigen progression or an adverse event was 0.742, similar to previously published utilities for nonprogressed prostate cancer states. Prostate specific antigen progression was associated with a utility decrement of between 0.062 and 0.134 depending on the mapping algorithm used. Of adverse events considered in our analysis musculoskeletal events were associated with the greatest effects on patient utility with a decrement of between 0.029 and 0.086. The 4 mapping algorithms generated similar utility estimates, although values derived from SF-12 were consistently lower than those derived from EORTC QLQ-C30.
  
  
  CONCLUSIONS
  Prostate specific antigen progression status and the incidence of treatment and disease related adverse events result in significant decrements to patient health related quality of life. By slowing prostate specific antigen progression degarelix may improve patient utility and the health related quality of life burden.
authors.affiliation: BresMed, Sheffield, United Kingdom. Electronic address: dlee@bresmed.co.uk.
authors.forename: Dawn
authors.initials: D
authors.lastname: Lee
authors.affiliation: BresMed, Sheffield, United Kingdom.
authors.forename: Sandy Kildegaard
authors.initials: SK
authors.lastname: Nielsen
authors.affiliation: BresMed, Utrecht, The Netherlands.
authors.forename: Marjolijn
authors.initials: M
authors.lastname: van Keep
authors.affiliation: Ferring International PharmaScience Center, Copenhagen, Denmark; Center for Medical Technology Assessment, Linköping University, Linköping, Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Andersson
authors.affiliation: Sunderland Royal Hospital, Sunderland, United Kingdom.
authors.forename: Damien
authors.initials: D
authors.lastname: Greene
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009842:Oligopeptides / Q000627:therapeutic use*; D017430:Prostate-Specific Antigen; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011788:Quality of Life; D011795:Surveys and Questionnaires
chemical_list: D018931:Antineoplastic Agents, Hormonal; D009842:Oligopeptides; C431566:acetyl-2-naphthylalanyl-3-chlorophenylalanyl-1-oxohexadecyl-seryl-4-aminophenylalanyl(hydroorotyl)-4-aminophenylalanyl(carbamoyl)-leucyl-ILys-prolyl-alaninamide; D017430:Prostate-Specific Antigen; D016729:Leuprolide
keywords: cost-benefit analysis; drug therapy; prostatic neoplasms; quality of life; questionnaires