cyproterone and Cardiovascular-Diseases

To evaluate the effects of a pill with drospirenone (3 mg) plus ethinyl E(2) (20 μg) (DRP/20EE) alone or associated with metformin or cyproterone acetate (CPA) on some metabolic cardiovascular risk factors in women with polycystic ovary syndrome (PCOS).. Randomized, open-label clinical trial.. Academic medical clinic.. Forty-eight hirsute women with PCOS.. Patients were randomized to treatment with DRP/20EE or with DRP/20EE plus metformin (1,500 mg/d) or with DRP/20EE plus CPA (12.5 mg/d, 10 days per cycle) for 6 months.. Blood pressure, lipid profile, and indexes of glucose tolerance and insulin sensitivity were assessed before and after 6 months of treatment.. Body mass index and blood pressure were not modified by any treatment. Treatment with DRP/EE20 did not change the lipid profile; DRP/EE20 plus metformin significantly increased high-density lipoprotein cholesterol concentrations; DRP/EE20 plus CPA significantly increased triglycerides and total cholesterol. The area under the curve for insulin was significantly decreased by DRP/EE20 and DRP/EE20 plus metformin, but it was significantly increased by DRP/EE20 plus CPA. Treatment with DRP/EE20 plus CPA significantly increased the homeostasis model assessment of insulin resistance index and significantly reduced the glucose to insulin ratio index. Treatment with DRP/EE20 significantly increased the glucose to insulin ratio index.. Treatment with DRP/EE20 improved insulin sensitivity in hirsute women with PCOS, with no deterioration of lipid profile. This effect was not ameliorated by the addition of metformin. The positive metabolic effects of DRP are abolished by the concomitant use of CPA.

Topics: Administration, Oral; Adolescent; Adult; Androgens; Androstenes; Blood Pressure; Cardiovascular Diseases; Cyproterone; Dose-Response Relationship, Drug; Drug Therapy, Combination; Estrogens; Ethinyl Estradiol; Female; Glucose; Humans; Hypoglycemic Agents; Insulin; Lipids; Metformin; Mineralocorticoid Receptor Antagonists; Polycystic Ovary Syndrome; Risk Factors; Young Adult

Topics: Androgen Antagonists; Breast; Buserelin; Cardiovascular Diseases; Cyproterone; Cyproterone Acetate; Diethylstilbestrol; Goserelin; Humans; Male; Prospective Studies; Prostatic Neoplasms

Two randomized trials were started in 1976 by the European Organization for Research on Treatment of Cancer urological group. Trial 30761 compared 1 mg. diethylstilbestrol orally 3 times daily to 250 mg. oral cyproterone acetate daily and to 500 mg. medroxyprogesterone acetate intramuscularly 3 times weekly for 8 weeks, then 200 mg. orally daily. Trial 30762 compared 3 mg. diethylstilbestrol to 560 mg. estramustine phosphate orally for 8 weeks and then 280 mg. daily. The 239 patients in study 30761 and 226 in study 30762 were evaluated for cardiovascular toxicity during treatment. Various types of side effects (fluid retention, hypertension, electrocardiographic changes, myocardial infarction and thromboembolic disease) and their degrees of severity were analyzed. In both studies the most frequent type of cardiovascular toxicity was represented by fluid retention. Cardiovascular toxicity as a whole was higher with diethylstilbestrol than with estramustine phosphate or medroxyprogesterone acetate therapy, and was the lowest with cyproterone acetate therapy. The risk of severe cardiovascular complications developing was the highest during the first 6 months of treatment. Increasing age, body weight greater than 75 kg. and, especially, the presence of previous cardiovascular disease represented adverse factors in the development of cardiovascular toxicity.

Topics: Aged; Body Weight; Cardiovascular Diseases; Clinical Trials as Topic; Cyproterone; Cyproterone Acetate; Diethylstilbestrol; Estramustine; Europe; Humans; Male; Medroxyprogesterone; Medroxyprogesterone Acetate; Middle Aged; Nitrogen Mustard Compounds; Prostatic Neoplasms; Random Allocation; Time Factors

Patients with previously untreated category T3 to T4 Mo or Ml prostatic cancer were allocated randomly to receive 250 mg. cyproterone acetate per day, a loading dose of 500 mg. medroxyprogesterone acetate intramuscularly 3 times weekly for 8 weeks followed by 100 mg. orally twice daily, or 1 mg. diethylstilbestrol 3 times daily in a phase III trial (protocol 30761) performed by the genitourinary tract cooperative group of the European Organization for Research on the Treatment of Cancer. Of 236 patients entered 210 were eligible: 75 received cyproterone acetate, 71 medroxyprogesterone acetate and 64 diethylstilbestrol. Local and distant tumor response, time to progression, survival and toxicity were assessed. Patients treated with medroxyprogesterone acetate had a less favorable course with a shorter duration of survival and time to progression than those treated with the other 2 drugs. There was no significant difference between diethylstilbestrol and cyproterone acetate. Cardiovascular side effects were reported more often in patients treated with diethylstilbestrol than in those treated with cyproterone acetate but severe and lethal cardiovascular toxicity was relatively low in all groups. Other side effects were negligible. Further studies are required to establish the influence of effective hormonal treatment upon survival.

Topics: Aged; Bone Neoplasms; Carcinoma; Cardiovascular Diseases; Clinical Trials as Topic; Cyproterone; Cyproterone Acetate; Diethylstilbestrol; Europe; Follow-Up Studies; Humans; Male; Medroxyprogesterone; Medroxyprogesterone Acetate; Middle Aged; Prostatic Neoplasms; Random Allocation

We aimed to evaluate the alteration of cardiovascular and metabolic risk parameters of polycystic ovary syndrome (PCOS) patients after a 6-month treatment with an oral contraceptive (OC) containing cyproterone acetate (CPA).. Forty women with PCOS were evaluated at baseline and after treatment with an OC. Carotid intima-media thickness (CIMT), brachial artery flow-mediated dilatation (FMD), nitrate-mediated dilatation (NMD), high sensitive (hs)-CRP, lipid levels, index of glucose sensitivity, and homeostasis model assessment of insulin resistance index (HOMA) were assessed.. Mean CIMT was significantly elevated (0.03 ± 0.01 mm) (p < 0.05). There was a tendency of reduction in FMD, which was significant among overweight patients (p < 0.05). Total cholesterol, low-density lipid (LDL), and triglyceride levels were significantly elevated (p < 0.05).. CIMT as an indicator of early atherosclerosis and FMD as a finding of endothelial dysfunction seem to be deteriorated especially in overweight PCOS patients who were prescribed to OC containing cyproterone acetate for 6 months.

Topics: Blood Flow Velocity; Blood Glucose; Brachial Artery; Cardiovascular Diseases; Carotid Intima-Media Thickness; Cholesterol; Cholesterol, HDL; Cholesterol, LDL; Contraceptives, Oral, Combined; Cyproterone; Ethinyl Estradiol; Female; Humans; Polycystic Ovary Syndrome; Risk Factors; Testosterone; Triglycerides; Young Adult

15 patients with advanced carcinoma of the prostate were studied in a prospective trial during treatment with 200 mg cyproterone acetate daily by mouth. Changes in variables (salt-water balance, antithrombin III, fibrinolytic activity, plasma lipoproteins) known to influence the risk of cardiovascular complications were recorded during the initial two months. Blood and plasma volume were unchanged, whereas the 24 h urine volume and the urinary sodium excretion were transitory increased. The body weight was decreased. The antithrombin III concentration and the fibrinolytic activity were increased. The lipoprotein fractions HDL and LDL and the HDL/LDL quotient decreased. The recorded changes of cardiovascular risk factors indicate that the risk of water retention and thereby congestive heart failure is not increased during cyproterone acetate treatment. The risk for thrombembolic disease is rather decreased. The small changes in lipoprotein fractions can hardly affect the incidence of cardiovascular disease in elderly men with prostatic carcinoma.

Topics: Aged; Antithrombin III; Cardiovascular Diseases; Cyproterone; Cyproterone Acetate; Hemodynamics; Humans; Lipoproteins; Male; Middle Aged; Prostatic Neoplasms; Risk; Water-Electrolyte Balance