New drug on the way

It's a GnRH antagonist hormone therapy drug. A similar drug is Degarelix/Firmagon. The difference is Relugolix/Orgovyx is a daily tablet, and also it wears off faster than the injections when you stop taking it.

I'm not sure exactly what use cases NICE has approved it for, but it could also be used instead of the GnRH agonists (Zoladex, Prostap, and Decapeptyl) if NICE has agreed such use. In this case you would not need to start with a course of Bicalutamide.

Disclosure: I am a consultant to Accord, but I don't speak for them.

Edited by member 20 Jul 2024 at 12:11  | Reason: Not specified

In comparison with the GnRH agonists (Zoladex, Prostap, and Decapeptyl), GnRH antagonists are slightly less likely to produce cardiovascular events. This is why Degarelix/Firmagon has been used for patients at higher risk of cardiovascular events (as well as those initially diagnosed with spinal mets and at risk of spinal cord compression, because GnRH antagonists are faster acting).

So I could see Relugolix/Orgovyx being used instead of Degarelix/Firmagon for those who can reliably take daily medications, particularly for those who get significant injection site reactions with Degarelix/Firmagon. I could also see it being used for those on intermittent hormone therapy where the faster recovery after ceasing would be a strong benefit. Some others may prefer tablets to injections, but some prefer injections because they can't forget to take them.

A big factor in many areas is cost, and even when the cost difference is tiny, that can force the choice. I was talking with an oncologist at one hospital, and they have no say in which GnRH hormone therapy is given - the hospital forces them to use the cheapest. In many cases, this means there is no patient choice.

Edited by member 20 Jul 2024 at 12:11  | Reason: Not specified