Choosing the right treatment for patients diagnosed with advanced prostate cancer can be overwhelming. Two commonly prescribed drugs are Abiraterone and Enzalutamide. Both drugs have greatly improved the treatment of men with advanced or metastatic prostate cancer but they work in different ways and may not be appropriate for all patients.
Patients and caregivers often ask questions like, “What is the difference between Abiraterone and Enzalutamide?” or “Which treatment is better?” The answer depends on a number of factors, such as the overall health of the patient, medical history, stage of cancer, goals of treatment, and recommendations of the physician.
This Article provides a comparison between Abiraterone and Enzalutamide in the Philippines. Abiraterone vs Enzalutamide: Mechanism of action, approved uses, dosage, side effects, effectiveness, and cost are provided for better understanding of these treatment options by patients.
What is Abiraterone?
Abiraterone acetate is a prescription drug used to treat metastatic prostate cancer. It is a member of a class of medications called androgen biosynthesis inhibitors.
Prostate cancer cells often require male hormones, called androgens, especially testosterone, for growth. Abiraterone works by blocking an enzyme called CYP17, which is important in the production of testosterone in the body. Abiraterone reduces the levels of androgens, which helps to slow or stop the growth of prostate cancer cells.
Abiraterone is usually given with prednisone or prednisolone to help prevent some side effects associated with treatment. Zytiga and several generic Abiraterone tablets are common brand names.
What is Enzalutamide?
Another targeted therapy for advanced prostate cancer is enzalutamide. It is one of a group of medicines known as androgen receptor inhibitors.
Enzalutamide does not reduce testosterone production like Abiraterone. Instead , it blocks the action of testosterone on androgen receptors , preventing prostate cancer cells from receiving hormonal signals that stimulate cancer growth .
Enzalutamide is sold under the brand name Xtandi and also has generic versions in some countries.
Enzalutamide works by directly blocking the signalling of the androgen receptor and can therefore be effective even when prostate cancer has developed resistance to other hormone treatments.
Key Differences Of Abiraterone And Enzalutamide
| Feature | Abiraterone | Enzalutamide |
| Drug Class | Androgen biosynthesis inhibitor | Androgen receptor inhibitor |
| How it Works | Reduces testosterone production | Blocks testosterone action |
| Steroid Requirement | Requires prednisone | Usually no steroid needed |
| Administration | Taken on an empty stomach | Can be taken with or without food |
| Common Brand | Zytiga | Xtandi |
| Main Use | Advanced/metastatic prostate can cer | Advanced/metastatic prostate cancer |
How Each Medicine Works
How Abiraterone Works
Abiraterone blocks the CYP17 enzyme found in the testes, adrenal glands, and prostate tumor tissue. This enzyme is essential for producing androgens. Lower androgen levels can slow the progression of hormone-sensitive prostate cancer.
How Enzalutamide Works
Enzalutamide targets androgen receptors directly. It prevents testosterone from binding to cancer cells and also interferes with multiple signaling pathways involved in tumor growth.
Because these medicines target prostate cancer differently, oncologists may choose one treatment over another based on individual patient characteristics.
Approved Uses
Both medicines are approved for treating various stages of advanced prostate cancer.
Abiraterone Uses
- Metastatic castration-sensitive prostate cancer (mCSPC)
- Metastatic castration-resistant prostate cancer (mCRPC)
- High-risk advanced prostate cancer
Enzalutamide Uses
- Metastatic castration-sensitive prostate cancer
- Metastatic castration-resistant prostate cancer
- Non-metastatic castration-resistant prostate cancer
Patients should always follow the treatment plan recommended by their oncologist.
Dosage and Administration
Abiraterone Dosage
The standard dose is typically 1,000 mg once daily taken on an empty stomach. It is commonly administered with prednisone.
Patients should avoid eating for at least two hours before and one hour after taking Abiraterone.
Enzalutamide Dosage
The usual recommended dose is 160 mg once daily. It may be taken with or without food.
Patients should take the medicine exactly as prescribed and should not adjust doses without medical supervision.
Side Effects Comparison
| Side Effects | Abiraterone | Enzalutamide |
| Fatigue | Common | Common |
| High Blood Pressure | Common | Common |
| Joint Pain | Common | Common |
| Liver Function Changes | More common | Less common |
| Fluid Retention | Common | Less common |
| Seizures | Rare | Rare but possible |
| Hot Flashes | Common | Common |
Patients experiencing severe side effects should contact their healthcare provider immediately.
Effectiveness Comparison
Both abiraterone and enzalutamide have demonstrated efficacy in clinical trials for the treatment of advanced prostate cancer.
Enzalutamide is also highly effective and has been shown in some studies to have longer progression-free survival in certain patient populations. Abiraterone is still very effective and is widely used around the world.
But there is no one-size-fits-all answer to the question, “Which is better: Abiraterone or Enzalutamide?” Treatment decisions will always be individualized based on:
- Overall health condition
- Existing medical conditions
- Previous cancer treatments
- Potential drug interactions
- Physician recommendations
- Patient preference
Cost Comparison in the Philippines
The cost of prostate cancer drugs can differ depending on the brand, strength, manufacturer and supplier.
Generic Abiraterone tablets are generally cheaper than branded ones. Likewise, generic Enzalutamide may present opportunities for cost savings over the original brands.
Before buying, patients in the Philippines are advised to shop around among reputable and licensed suppliers.
Which Treatment May Be Suitable?
Abiraterone can be considered in patients who can safely take corticosteroids and need testosterone production to be suppressed.
Enzalutamide may be preferred for patients that cannot tolerate steroids or that may benefit from direct androgen receptor inhibition.
The final decision about the best course of treatment should be made by a trained oncologist, who will review the patient’s full medical history.
Frequently Asked Questions
Is Abiraterone better than Enzalutamide?
Both medicines are effective. The choice depends on individual patient factors and physician recommendations.
Can Abiraterone and Enzalutamide be taken together?
Combination therapy may be considered in specific situations, but treatment decisions should only be made by an oncologist.
Does Abiraterone require steroids?
Yes. Abiraterone is typically prescribed together with prednisone or prednisolone.
Which medicine has fewer side effects?
Side effects differ between individuals. Some patients tolerate Abiraterone better, while others respond well to Enzalutamide.
Where to Buy Abiraterone and Enzalutamide in the Philippines
Patients can explore options through trusted suppliers like LetsMeds for Abiraterone tablets or Enzalutamide capsules in the Philippines LetsMeds supplies a wide range of branded and generic cancer medicines at competitive prices and offers delivery across Manila, Quezon City, Cebu, Davao, Makati, Taguig, and other regions in the Philippines.
Conclusion
Both Abiraterone and Enzalutamide have transformed the treatment landscape for advanced prostate cancer. While both therapies are highly effective, they differ in their mechanism of action, administration requirements, side effect profiles, and cost.
The decision between Abiraterone vs Enzalutamide should be made in consultation with an experienced oncologist who can recommend the most suitable treatment based on the patient's individual medical needs.
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