Adherence of Various ADT Options

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Clinical experience with oral androgen deprivation therapy (ADT) has demonstrated excellent adherence rates, with patients showing high reliability in taking daily relugolix. The medication requires a loading dose of 3 pills on the first day, followed by once-daily dosing thereafter. Practical adherence strategies include timing doses consistently, using pill calendars or timers, and integrating the medication into daily routines. Unlike complex oral regimens such as abiraterone with prednisone and food restrictions, relugolix offers straightforward administration without dietary considerations.

The portability advantage of oral ADT cannot be overstated, particularly for patients who travel frequently or have scheduling conflicts with injection appointments. This flexibility eliminates the concern about missing doses due to travel or clinic accessibility issues. Real-world experience from clinical practice, including participation in the HERO trial, has shown minimal compliance issues, with patients who switched from oral to injectable therapy due to various reasons often requesting to return to oral formulations.

Monitoring compliance with oral ADT is straightforward through testosterone level assessment, allowing physicians to objectively evaluate treatment adherence. The combination of patient preference for oral therapy, high adherence rates demonstrated in clinical trials, and the practical advantages of home administration make oral ADT an attractive option for most patients. The ability to maintain treatment continuity regardless of travel or scheduling constraints represents a significant quality-of-life improvement compared to the rigid scheduling requirements of injectable therapies.