Originally Posted by rhome
Has anyone been on Firmagon as opposed to Lupron. Does anyone know the basic differences. Any Preferences.
I had never heard of the brand name, but the scientific name for Firmagon is degarelix, and it was only recently approved by the FDA in the US (December 3, 2008). It is the first drug approved in its class: LHRH antagonists.
Lupron (and Zoladex, Viadur, and Trelstar) are all LHRH agonists and have been around for a while. In fact, Zoladex has been around so long that its patent is expiring this year. That's good news for patients as the price for this expensive drug should plunge, and that should put downward price pressure on its competitors. (The patent for Lupron will expire within a few more years.)
Both the LHRH agonists and the LHRH antagonist have the same fundamental effect: lowering testosterone produced from the testes to castrate levels. However, the agonists do this by reducing LH (luteinizing hormone) while the antagonist (Firmagon) does this by blocking LHRH (luteinizing hormone releasing hormone). A significant advantage of Firmagon is that there is no surge in testosterone before the drug drastically reduces it, as is the case with the agonists. (However, there are several drugs that can block the surge, which is known as "flare", so this is not a major issue with the agonists, just an issue to be properly managed. In fact, flare usually is not a problem even if it does occur (my case); in some cases, such as existing spinal metastases, it can result in irreversible crippling of the patient. There is excellent coverage of the mechanics of hormonal blockade therapy in the book "A Primer on Prostate Cancer - The Empowered Patient's Guide," (Strum & Pogliano).
I seem to recall hearing that degarelix caused a very rapid and profound drop in testosterone, but I'm not sure about that. I have not heard much about this fairly new drug.
I suggest you go to www.pubmed.gov, a site we can use on this board because the site is Government sponsored, and search for degarelix. You can click on the hypertext titles of the resulting list of medical research papers to get free access to descriptions of the research.