agonist versus antagonist issue

[SimMartin]

Switching to Degarelix or maybe the oral version after 5 months of monthly goserelin implant ?

With the evidence on cardio and other risks reduced with using an antagonist such as degarelix or relugolix what’s the view on the benefits of doing this when having already started in the RT plus goserelin regime with G9 locally contained (as far as we know!)

Price and insurance approval may be an issue but with a free choice ? As I may decide that despite suggestions that 6months may be enough i think that 12 or even 18 months is probably a reasonable target with my comorbidities and despite the fact that 4-5 months in Zoladex monthly has proven to have relatively mild if irritating side effects I am aware of the impact with longer term use and that must CV event actually happen in the first 12 months. It also seems that the impact on FSH may have benefits with respect to recurrence- sadly my endocrine biochemistry is a bit rusty these days and I lost my way in that sub topic !

[GP24]

You take goserelin or degarelix/relugolix to lower the testosterone level. It can be achived with both agonists and antagonists. You can switch before the next goserelin injection is scheduled or even earlier.

[Tall_Allen]

I think there is a cardiac benefit to an antagonist, especially if there is a history. It doesn't matter if you've used an agonist in the past.

[EchoII in reply to Tall_Allen]

Which drugs are agonists and which are antagonists?

[SimMartin in reply to EchoII]

My understanding is that medications such as lupron and Zoladex are agonists and drugs such as degarelix and the newer oral version relugolix are antagonists - they work in different ways on shutting down testosterone production. (Please correct me if I’m wrong though !)

[EchoII in reply to SimMartin]

sounds like everything is antagonist.

[SimMartin in reply to EchoII]

lol typo ! Corrected 🤦🏻‍♂️