Does the pharmacological class effect between the different luteinizing hormone releasing hormone analogues used in the treatment of prostate cancer have to be assumed?

Introduction: Evidence-based medicine is transforming clinical practice because of its progressive implantation. Objectives: We considered studying whether LHRH analogues are agents of the same pharmacological class, i.e., whether they have the same clinical effect, using the approach to evidence-based medicine. Material and methods: PubMed was used as the main source of search. We have reviewed the evidence on the alleged drug class effect between analogues and the existing bibliographic support for their use in various medical indications. An evidence level and degree of recommendation have been assigned to each conclusion based on the Scottish Intercollegiate Guidelines Network. Results: There are no studies designed to answer the question of a class effect between LHRH analogues or agonists. Reviews and meta-analyses have been performed on many other issues related to therapeutic management either with analogues, alone or in combination with surgery or radiation therapy. Direct comparisons do not allow for obtain definitive conclusions. Indirect evidence is obtained from randomized studies comparing the different LHRH analogues to other treatments used to obtain androgen deprivation. Other issues related to pharmacokinetics and pharmacodynamics supporting either the existence or non-existence of class effect were evaluated. Conclusions: The current available evidence is not enough to support a presumed "drug class effect" among the various analogues in the treatment of prostate carcinoma. (C) 2010 AEU. Published by Elsevier Espatia, S.L. All rights reserved.