News & Notes

Abstract

Listen

Translate article

AbstractLoop diuretics may increase bone loss in menContinuous use of a loop diuretic could double the rate of bone loss in elderly men, according to a new analysis of the Osteoporotic Fractures in Men study (Arch Intern Med 2008; 168: 735–40).This analysis of a subgroup of 3269 of the original 5995 men over 65 for whom a DEXA scan was available at baseline and after a mean follow‐up of 4.6 years identified 84 who had continuously used a loop diuretic, 181 with intermittent use and 3004 never‐users.After adjustment for risk factors, the mean annual rate of decline in bone mineral density (BMD) at the hip was 0.78 per cent among continuous users, 0.58 per cent with intermittent use and 0.33 per cent among never‐users; there were similar trends at the femoral neck and trochanter.Cochrane reviews finasterideTreatment with finasteride reduces the risk of prostate cancer in men at increased risk by about one‐quarter, a new Cochrane review reveals (Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD007091. DOI: 10.1002/ 14651858.CD007091).The risk reduction with finasteride did not vary with age, ethnicity or family history but was not evident in men with prostate‐specific antigen >4ng/ml. The analysis was dominated by the Prostate Cancer Prevention Trial, which reported an increase in men with high‐grade tumours during finasteride therapy.Only one report of dutasteride was included, suggesting a 51 per cent risk reduction in cancers detected.New GnRH antagonistsGermany is the first country in Europe to have the new GnRH receptor antagonist abarelix (Plenaxis) for the treatment of hormone‐dependent prostate cancer. Manufacturer Speciality European Pharma says that abarelix, by contrast with agonist therapies, reduces testosterone levels rapidly and is not associated with hormonal surge or flare. Registration is now underway across Europe.Phase III data presented at the 23rd Annual European Association of Urology Congress in Milan revealed the rapid onset of effect with Ferring's GnRH antagonist degarelix. After 14 days, serum testosterone was <5ng/ml in all patients treated with degarelix and in 18 per cent of those assigned to monthly leuprorelin. The median reduction in prostate‐specific antigen was 64 per cent with degarelix and 18 per cent with the LHRH analogue.Transdermal testosterone little benefit for womenWomen who report decreased sexual satisfaction derive little benefit from transdermal testosterone, an Australian trial has shown (Ann Intern Med 2008; 148: 569–77).261 women aged 35–46 who reported decreased sexual satisfaction compared with historical experience were randomised to receive placebo or testosterone spray at doses of 56, 90 or 180µl for 16 weeks. Baseline morning serum free testosterone level was less than 3.8pmol/l.The primary endpoint was the number of satisfactory sexual events (SSEs) in the 28 days up to week 16.The rate ratios of SSEs compared with placebo for 56, 90 and 180µl doses were 1.34, 1.48 and 1.38, respectively; of these, only the response to the 90µl dose was statistically significant but the absolute difference was small – equivalent to an increase of 0.8 SSE per month. The commonest adverse effect was dose–related hypertrichosis at the site. Copyright © 2008 Wiley Interface Ltd