EFFICACY AND SAFETY OF LUTEINIZING-HORMONE-RELEASING HORMONE ANTAGONIST CETRORELIX IN THE TREATMENT OF SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA

As the life expectancy far men increases, more cases of benign prostat ic hyperplasia (BPH) will be expected. Symptomatic BPH causes morbidit y and can lower the quality of Life. We investigated whether short ter m administration of the LH-releasing hormone antagonist cetrorelix cou ld provide an improved treatment for men with BPH. Thirteen patients w ith moderate to severe symptomatic BPH were treated with cetrorelix (5 mg, sc, twice daily for 2 days followed by 1 mg/day, sc, for 2 months ). Patients were evaluated at baseline, during treatment;, and up to 1 8 months after therapy. We determined the effects of cetrorelix on the international Prostate Symptom Score (IPSS), Quality of Life score, s exual function, prostate size, uroflowmetry, and hormonal levels. Trea tment with cetrorelix produced a decline of 52.9% (P < 0.0001) in IPSS , a 46% improvement in the Quality of Life score (P < 0.001), a rapid reduction of 27% (P < 0.006) in prostatic volume, and an increase in p eak urinary flow rates by 2.86 mL/s. Serum testosterone fell to castra te levels on day 2, but was inhibited only by 64-74% during maintenanc e therapy, and after cessation of treatment returned to normal. During long term followup, most patients continued to show a progressive imp rovement in urinary symptoms (decline in IPSS from 67% to 72% at weeks 20 and 85, respectively) and an enhancement of sexual function, and p rostatic volume remained normal. Our study demonstrates that in patien ts with symptomatic BPH, treatment with cetrorelix is safe and produce s long term improvement.