Triptorelin therapy for lower urinary tract symptoms (LUTS) in prostate cancer patients: A systematic meta‐analysis

Author:

Barrett Ravina1ORCID,Birch Brian23ORCID

Affiliation:

1. School of Applied Sciences University of Brighton Brighton UK

2. University Hospital Southampton NHS Foundation Trust Southampton UK

3. School of Medicine University of Southampton Southampton UK

Abstract

AbstractObjectiveThis systematic meta‐analysis aimed to assess the effectiveness of triptorelin therapy in reducing lower urinary tract symptoms (LUTS) in men with prostate cancer (PCa).MethodsThe Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed. PubMed, Web of Science and EMBASE databases were searched for studies conducted between 2013 and 2023. Eligible studies included PCa patients undergoing androgen deprivation therapy (ADT) with triptorelin, with reported baseline and follow‐up International Prostate Symptom Scores (IPSS) and quality of life (QoL) data. The Newcastle–Ottawa Scale (NOS) was used to assess the risk of bias, and a random‐effects model was applied for the meta‐analysis.ResultsA total of 29 articles were identified, and three studies met the inclusion criteria. Triptorelin therapy showed a clinically significant reduction in IPSS over 48 weeks in PCa patients with moderate to severe LUTS. The meta‐analysis revealed a pooled effect size of 1.05 (95% CI: 0.65; 1.45), indicating a statistically significant improvement in LUTS. QoL also improved in patients receiving triptorelin therapy, although heterogeneity among the studies and a moderate to high risk of bias were noted.ConclusionTriptorelin therapy demonstrated a positive impact on LUTS in PCa patients. The meta‐analysis showed significant reductions in IPSS scores and improved QoL after 48 weeks of triptorelin treatment. However, the results should be interpreted cautiously due to study heterogeneity and potential biases. Further well‐designed studies are needed to confirm these findings and determine the optimal use of triptorelin for managing LUTS in men with PCa.Implications for PracticeTriptorelin therapy may offer an effective treatment option for men with PCa experiencing moderate to severe LUTS. Its positive impact on QoL can lead to improved patient well‐being and treatment adherence. Clinicians should consider triptorelin as a potential treatment choice, especially in patients who may be reluctant to undergo surgical interventions for their LUTS. However, careful patient selection and close monitoring are essential due to the observed study heterogeneity and risk of bias. Future research should focus on evaluating triptorelin's cost‐effectiveness and comparing its efficacy with other LH‐RH agonists in managing LUTS in PCa patients.Video Abstract: URL (Reviewers/Editors to select from) Link 1: https://brighton.cloud.panopto.eu/Panopto/Pages/Viewer.aspx?id=071419c8-1ad5-4502-a222-b04300c2ca5eLink 2: https://brighton.cloud.panopto.eu/Panopto/Pages/Viewer.aspx?id=b6305a8a-b977-4fcd-a69e-b04300bed728

Publisher

Wiley

Subject

General Medicine

Reference48 articles.

1. Cancer Research UK.Prostate cancer statistics [Internet].2019[cited 2023 April 12]. Available from:https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/prostate-cancer#heading-FiveAccessed Dec 20 2022.

2. NHS Digital.Cancer registration statistics England [internet].2019[cited 2022 Dec 21]. Available from:https://digital.nhs.uk/data‐and‐information/publications/statistical/cancer‐registration‐statistics/england‐2019/the‐rate‐of‐people‐dying‐from‐cancer‐in‐england‐continues‐to‐decrease#:~:text=The%20incidence%20rate%20for%20prostate 2010%20to%2046%20in%202019

3. Excellence NIfHaC.Suspected cancer: recognition and referral [NG12].

4. England PH.Prostate cancer risk management programme: overview.

5. Prostate cancer screening with prostate-specific antigen (PSA) test: a clinical practice guideline

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