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Is Firmagon (degarelix) the same as Lupron?

Medically reviewed by Carmen Fookes, BPharm. Last updated on Nov 7, 2021.

Official answer

by Drugs.com

No, Firmagon (degarelix) is not the same as Lupron but they are both hormone deprivation treatments that may be used for the treatment of advanced prostate cancer.

Firmagon is a gonadotropin-releasing hormone (GnRH) receptor antagonist and Lupron is a GnRH agonist. Even though they appear to have opposing mechanisms of action, they both achieve the same result, which is a significant lowering of testosterone levels. Firmagon works by binding to pituitary GnRH receptors, reducing the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), and subsequently testosterone. Lupron works by stimulating GnRH receptors so much that it desensitizes the receptor and down-regulates the secretion of LH and FSH and subsequently testosterone. Because it works in this way, infusions of Lupron initially produce a transient increase in testosterone, but continued stimulation results in a profound decrease in circulating testosterone.

Put simply, degarelix takes a more direct path to testosterone suppression than Lupron. Degarelix is an antagonist that immediately stops testosterone production, preventing a testosterone surge and eliminating the need for any additional therapies. Lupron is an agonist that desensitizes the GnRH receptor but causes an initial surge in testosterone and may require additional medication.

By day 3, Firmagon causes a 94% reduction in testosterone levels, whereas Lupron causes a 65% INCREASE in testosterone levels by day 3. But by 28 days, both Firmagon and Lupron achieve a 98% reduction in testosterone levels.

Research has also indicated that, on the whole, degarelix improves health-related quality of life (HRQoL) in patients with prostate cancer more than what Lupron does. Patients taking degarelix were less likely to experience a deterioration in their mental health HRQoL, such as anxiety or depression, and had an overall improved level of health, compared with those taking Lupron. Lupron seemed to have a more favorable impact on bodily pain and insomnia.

References
  • Comparison of the Impact of Degarelix and Leuprolide on the Health-Related Quality of Life of Patients with Prostate Cancer: Results of a 12-Month Phase III Clinical Trial – Supplement https://www.urotoday.com/uij-archives/1304-supplements/50174-comparison-of-the-impact-of-degarelix-and-leuprolide-on-the-health-related-quality-of-life-of-patients-with-prostate-cancer-results-of-a-12-month-phase-iii-clinical-trial-supplement.html
  • Degarelix Updated 10/2021 AHFS Monograph https://www.drugs.com/monograph/degarelix.html
  • Firmagon (degarelix acetate) Updated 03/2020. Ferring Pharmaceuticals Inc. https://www.drugs.com/pro/firmagon.html#s-34090-1
  • Firmagon (degarelix acetate) https://firmagon.com/hcp/low-testosterone/
  • Lupron Depot (leuprolide acetate). Updated 02/2021. https://www.drugs.com/pro/lupron-depot.html

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