Firmagon (degarelix; Ferring/Astellas) is a gonadotropin-releasing hormone (GnRH) receptor antagonist that directly binds to GnRH receptors in the anterior pituitary gland, rapidly reducing the circulating gonadotropins luteinizing hormone (LH) and follicle-stimulating hormone (FSH), and leading to the rapid suppression of testosterone in men.
This mechanism stands in contrast to GnRH agonists that, over time, downregulate and desensitize GnRH receptors in the pituitary, leading to reduced secretion of LH and downstream testosterone. However, GnRH agonists are also accompanied by a biochemical surge in testosterone known as a flare that typically requires co-administration of antiandrogens to help prevent flare side effects such as spinal cord compression, bone pain, and urethral obstruction.
Key Topics Covered:
Firmagon: Prostate cancer
List of Figures
Figure 1: Firmagon sales for prostate cancer across the US, Japan, and five major EU markets, by country, 2017-26
List of Tables
Table 1: Firmagon sales for prostate cancer across the US, Japan, and five major EU markets, by country ($m), 2017-26
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