PURPOSE: The purpose of this study was to evaluate the feasibility of using IAD, as a steroidal antiandrogen (cyproterone acetate) monotherapy, for prostate cancer. MATERIALS AND METHODS: A total of 43 prostate cancer patients (Stage A to C in 27, D1 in 2 and D2 in 14) were reviewed. Androgen deprivation, with cyproterone acetate (200-300mg P.O/day), was continued until a serum prostate specific antigen (PSA) nadir was maintained for at least 3 months. Medication was then discontinued until the serum PSA reached a predetermined level. This cycle of treatment was repeated until there was a continual increase in the PSA irrespective of the medication. RESULTS: The mean observation period was 10.5 months, ranging from 4 to 28 months. In seven of the 43 patients, there was treatment failure before entering the off-treatment period of the 1st cycle. 17 of the remaining 36 patients completed the on-treatment during cycle 1, with a median time to PSA nadir of 4 months. Seven patients completed cycle 1, with a median time off-treatment of 5 months (43% of the treatment cycle). Nineteen patients are still in the on-treatment intervals and 10 in the off-treatment intervals of their first cycles. Two patients completed the on-treatment of the 2nd cycle, with a median time to PSA nadir of 2.5 months. During the off-treatment interval, most patients reported an improvement in the symptoms associated with androgen suppression. CONCLUSIONS: IAD, using cyproterone acetate monotherapy, is a feasible alternative for continuous androgen deprivation in the treatment of prostate cancer. It also results in the reduction of toxicity, cost of treatment and possibly a delay in the tumor progression.
Cyproterone Acetate* ; Cyproterone* ; Humans ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Treatment Failure

Cyproterone acetate is an antiandrogenic drug that has been used in prostatic cancer. The drug is thought to be well-tolerated but has hepatotoxic effects. An 89 year-old man treated with cyproterone acetate 300 mg/d for prostatic cancer presented with a hepatotoxic reaction. Toxic hepatitis was diagnosed and cyproterone acetate was stopped immediately. The patient was treated with supportive management and a corticosteroid, but he died 28 days after administration due to liver failure. A liver biopsy performed after his death revealed the presence of acute hepatitis with cirrhosis. Underlying cirrhosis was not suspected before his death. Ultimately, the case was diagnosed as fulminant hepatic failure due to cyproterone acetate with underlying cryptogenic liver cirrhosis. This case and current literature highlight the hepatotoxic potential of cyproterone acetate and illustrate the importance of clinical surveillance, especially in patients with unrecognized liver disease.
Biopsy ; Cyproterone ; Cyproterone Acetate ; Drug-Induced Liver Injury ; Fibrosis ; Hepatitis ; Humans ; Liver ; Liver Cirrhosis ; Liver Diseases ; Liver Failure ; Liver Failure, Acute ; Prostatic Neoplasms

The current treatment of acne vulgaris utilizing both topical and systemic agents i eviewed. New therapeutic agents such as the retinoids and their newer analogus etretin and RO-15-0778, antiandrogens cyproterone acetate alone and in combination with estrogen, a eutectic mixture of local anesthetics (EMLA), minoxidil for hair growth, mupirocin and ketoconazole. A partial list of therapeutic agents whose futher use is under review in terms of their safety or efficacy.
Acitretin ; Acne Vulgaris ; Androgen Antagonists ; Anesthetics, Local ; Cyproterone Acetate ; Drug Therapy* ; Estrogens ; Hair ; Humans ; Ketoconazole ; Minoxidil ; Mupirocin ; Retinoids

The search for nonhormonal pharmacological agents capable of reducing out flow obstruction caused by benign prostatic hyperplasia (BPH) began in the 1970s when alpha adrenergic receptors were demonstrated within the smooth muscle element of prostatic adenomas, the prostatic capsule, and the bladder neck. Recently, many studies have confirmed that the alpha adrenoceptor blockade sub-jectively and objectively reduces symptoms and urodynamic parameters in bladder outflow obstruction. Very longterm effects of the alpha blockade upon the pro-state are not yet known. There is no direct evidence of a decrease in the stromal smooth muscle bulk or in the total prostate volume after longterm treatment with alpha adrenoceptor blockers in man. The endocrinebased therapies, such as stilbestrol, luteinizing hormonereleasing hormone analogues, antiandrogens flutamide, and cyproterone acetate, have sometimes been used to treat BPH, but with a limited efficacy and prominent sideeffects such as loss of libido, impotence, hot flushes, and gynecomastia. Although it has been shown that some of these therapies may shrink the prostate, the sideeffects are intolerable to most patient. On the other hand, new 5 alpha reductaseinhibiting agents are able to block the effects of androgen within the prostate without a systemic antiandrogen activity. Since the effects of androgens are particularly directed at the glandular element of the prostate rather than at the smooth muscle, the combined use of alphaadrenoceptor blockers and 5 alphareductase inhibitors could theoretically produce an additive effect in the treatment of BPH. The indications of medical treatment for BPH include patients with mild to moderate symptoms, especially if they are reluctant to undergo surgery, and those who are not medically eligible to surgery.
Androgen Antagonists ; Androgens ; Cyproterone Acetate ; Diethylstilbestrol ; Erectile Dysfunction ; Flutamide ; Gynecomastia ; Hand ; Humans ; Libido ; Lutein ; Male ; Muscle, Smooth ; Neck ; Prostate ; Prostatic Hyperplasia* ; Receptors, Adrenergic, alpha ; Urinary Bladder ; Urodynamics

OBJECTIVETo investigate changes of serum total oxidation status (TOS) and total antioxidant status (TAS) and their association with apolipoprotein (a) [Apo(a)] in patients with polycystic ovary syndrome (PCOS) combined with infertility.

MWTHODSNinety patients with PCOS and infertility were selected as the study group, including 45 patients treated with antioxidants combined with Diane-35(group A) and 45 with Diane-35 therapy only (group B), with 45 healthy volunteers with normal menstruation and normal dual phase basic body temperatures as the control group. Serum TOS of the participants was determined by dual xylenol orange method, and serum TAS was determined with ABTS method; plasma Apo(a) level was determined by dual wavelength immune transmission turbidity method.

RESULTSBefore treatment, serum TOS, OSI, and Apo(a) levels were significantly higher and TAS level was significantly lower in the study group than in the control group (P<0.05). Serum TOS, OSI, and Apo (a) were significantly lowered and TAS was significantly increased in group A after the therapy as compared with the levels before therapy and the levels in group B. The rate of natural recovery of menstruation was significantly higher and the incidence of cardiovascular disease was significantly lower in group A than in group B (P<0.05). Pearson correlation analysis showed that serum TOS and OSI were positively correlated with plasma Apo(a) (r=0.524 and 0.531, P<0.05), and serum TAS was negatively correlated with plasma Apo(a) (r=-0.519, P<0.05).

CONCLUSIONAntioxidant therapy can lower TOS, OSI and Apo(a) levels and increase TAS level to lessen oxidative stress, improve the prognosis, and reduce the risks of cardiovascular disease in patients with PCOS and infertility.

Antioxidants ; metabolism ; Apoprotein(a) ; blood ; Cyproterone Acetate ; therapeutic use ; Drug Combinations ; Ethinyl Estradiol ; therapeutic use ; Female ; Humans ; Infertility, Female ; blood ; Oxidative Stress ; Polycystic Ovary Syndrome ; blood ; drug therapy

No abstract available.
*Castration ; Cyproterone Acetate/adverse effects/therapeutic use ; Gonadotropin-Releasing Hormone/agonists/metabolism ; Humans ; Male ; Medroxyprogesterone Acetate/adverse effects/therapeutic use ; Physicians/*psychology ; Prostatic Neoplasms/etiology ; Psychotherapy ; Sex Offenses/*prevention & control

Administration, Oral ; Adult ; Biomarkers ; analysis ; Budd-Chiari Syndrome ; chemically induced ; diagnosis ; pathology ; Cyproterone Acetate ; adverse effects ; therapeutic use ; Diagnosis, Differential ; Ethinyl Estradiol ; adverse effects ; therapeutic use ; Female ; Humans ; Liver ; diagnostic imaging ; pathology ; Menstruation Disturbances ; drug therapy ; Radiography

OBJECTIVETo investigate the clinical efficacy of integrative traditional Chinese and Western medicine on polycystic ovarian syndrome (PCOC).

METHODSSixty-three patients with polycystic ovarian syndrome were randomly allocated into 2 groups, 31 patients orally administered with diane-35 in the Western medicine group (WMG) and 32 patients treated with conventional controlled medicine plus modified Yougui Pill in the integrative medicine group (IMG). Changes of relevant hormones and clinical syndromes in patients were detected before treatment, after 3 cyclic treatment and at the 6th cycle after treatment.

RESULTSThe levels of relevant hormones and the indexes of B-ultrasonic were obviously improved after treatment in the two groups. But 6 cycles after treatment, these changes restored to the baseline as those before treatment in WMG, while maintained in IMG (P < 0.01). What's more, the normalization of menstruation, ovulation and pregnancy rate in IMG were significantly higher than those in WMG (P < 0.01).

CONCLUSIONDiane-35 combined with modified yougui pill in treating polycystic ovarian syndrome not only shows marked short-term effect, but could consolidate the curative effect.

Adult ; Androgen Antagonists ; therapeutic use ; Cyproterone Acetate ; therapeutic use ; Drug Administration Schedule ; Drug Combinations ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Ethinyl Estradiol ; therapeutic use ; Female ; Humans ; Phytotherapy ; Polycystic Ovary Syndrome ; drug therapy ; Tablets

BACKGROUNDWhile combined oral contraceptives (COCs) are commonly used to treat polycystic ovary syndrome (PCOS), comparative data regarding metabolic effects of different progestogens on this patient population are missing. This study aimed to compare the different effects of drospirenone (DRP)-containing COCs with cyproterone acetate (CPA)-containing COCs, combined with metformin and lifestyle modifications in women with PCOS and metabolic disorders.

METHODSNinety-nine women with PCOS and a metabolic disorder between January 2011 and January 2013 were enrolled into this prospective randomized clinical trial. Participants were randomized into two groups such as DRP-containing COCs, and CPA-containing COCs. Participants took COCs cyclically for 6 months, combined with metformin administration (1.5 g/d) and lifestyle modifications (diet and exercise). Clinical measures and biochemical and hormone profiles were compared. Comparisons for continuous variables were evaluated with paired and unpaired Student's t-tests. The Wilcoxon signed rank test was used when the data were not normally distributed. Analysis of covariance was used to control for age, body mass index (BMI), and baseline data of each analyzed parameter when compared between the two groups.

RESULTSA total of 68 patients have completed the study. The combination regimen of COCs, metformin, and lifestyle modifications in these patients resulted in a significant decrease in BMI, acne, and hirsutism scores when compared to baseline levels in both groups (P < 0.05). Blood pressure (BP) was significantly different in the CPA group when compared to baseline (75.14 ± 6.77 mmHg vs. 80.70 ± 5.60 mmHg, P < 0.01), and after 6 months of treatment, only the change in systolic BP was significantly different between the two groups (4.00 [-6.00, 13.00] mmHg vs. -3.50 [-13.00, 9.00] mmHg, P = 0.009). Fasting glucose, fasting insulin, and homeostasis model assessment-insulin resistance decreased significantly in the DRP group (5.40 ± 0.41 mmol/L vs. 5.21 ± 0.32 mmol/L, P = 0.041; 13.90 [10.50, 18.40] μU/ml vs. 10.75 [8.60, 13.50] μU/ml, P = 0.020; 3.74 [2.85, 4.23] vs. 2.55 [1.92, 3.40], P = 0.008) but did not differ between the two groups. While individual lipid profiles increased in both groups, no statistically significant difference was observed.

CONCLUSIONSDRP-containing COCs combined with metformin and lifestyle modifications could better control BP and correct carbohydrate metabolism in women with PCOS and metabolic disorders compared with CPA-containing COCs.

TRIAL REGISTRATIONChinese Clinical Trial Registry, ChiCTR-TRC-11001143; http://www.chictr.org.cn/showproj.aspx?proj=8395.

Adolescent ; Adult ; Androstenes ; administration & dosage ; Carbohydrate Metabolism ; Contraceptives, Oral ; administration & dosage ; Cyproterone Acetate ; administration & dosage ; Female ; Humans ; Insulin Resistance ; Life Style ; Lipids ; blood ; Metformin ; administration & dosage ; Polycystic Ovary Syndrome ; blood ; drug therapy ; metabolism ; Prospective Studies

OBJECTIVETo compare the difference in clinical efficacy on polycystic ovary syndrome (PCOS) between electroacupuncture (EA) and dyne-35 and to explore the effect mechanism.

METHODSSixty-five patients were randomized into an EA group (33 cases) and a western medication group (32 cases). In the EA group, the selected acupoints were Danzhong (CV 17), Qimen (LR 14), Zhongwan (CV 12), Tianshu (ST 25), Guanyuan (CV 4), Zigong (EX-CA 1), Sanyinjiao (SP 6), Zusanli (ST 36) and Taichong (LR 3), etc. After the arrival of qi, electric stimulation was attached to the acupoints for 30 min. The treatment was given 3 times a week. In the western medication group, dyne-35 was prescribed on the 5th day of natural menstruation or withdrawal bleeding, one tablet a day, continuously for 21 days. The treatment cycle was 3 months in the two groups. The menstrual condition, body mass, body mass index (BMI), serum testosterone (T), luteinizing hormone (LH), follicle-stimulating hormone (FSH) and LH/FSH were compared before and after treatment in the two groups. The clinical efficacy was assessed in the two groups.

RESULTSThe total effective rate was 90.6% (29/32) in the EA group and was 93.3% (28/30) in the western medication group. The efficacy was similar in the two groups (P > 0.05). After treatment, the levels of LH and LH/FSH were all reduced significantly in the two groups (all P < 0.01). After treatment, T level in serum was reduced apparently in the western medication group (P < 0.05). Before and after treatment, the differences in body mass and BMI in the EA group were more significant than those in the western medication group (P < 0.01, P < 0.05).

CONCLUSIONEA is the effective method for PCOS, similar to that of dyne-35. The effect of it for weight loss is superior to dyne-35 and no apparent adverse reactions happen. The effect mechanism of EA is related to the regulation of serum sexual hormone levels and their ratio, as well as to the regulation of body lipid metabolism.

Acupuncture Points ; Adolescent ; Adult ; Cyproterone Acetate ; administration & dosage ; Drug Combinations ; Electroacupuncture ; Ethinyl Estradiol ; administration & dosage ; Female ; Follicle Stimulating Hormone ; blood ; Humans ; Luteinizing Hormone ; blood ; Polycystic Ovary Syndrome ; blood ; drug therapy ; therapy ; Young Adult