Effects Of Testosterone Suppression Research Articles

Die adjuvante Hormontherapie des Prostatakarzinoms nach lokaler Therapie im Kontext der evidenzbasierten Medizin

At present, prostate cancer is the most frequent malignant disease in German men. The aims of adjuvant hormone treatment are to increase progression free survival and improve cure rate. Risk factors for progression are a Gleason score > or =8, large tumor volumes, a high preoperative PSA (>15-29 ng/ml), penetration of the capsule, positive margins and lymph node metastasis. The type of hormone therapy (LHRH-nnalogues, non-steroidal anti-androgens, surgical castration) should be discussed with the patient. Bicalutamide seems to be an alternative for younger patients due to the lack of side effects of testosterone suppression.

Leuprolide acetate given by a subcutaneous extended-release injection: less of a pain?

Androgen deprivation therapy is a mainstay for the treatment of advanced prostate cancer. Hormonal therapy commonly consists of injection of gonadotropinhormone-releasing hormone agonists. Based on the need for improved convenience of administration, a novel formulation of leuprolide acetate (Eligard®; Atrix Laboratories Inc. & Sanofi Aventis) which incorporates a mixture of selected polymers and solvents to achieve sustained drug delivery after subcutaneous injection, was developed. The US Food and Drug Administration has approved 1-, 3-, 4- and 6-month formulations of leuprolide acetate. In clinical trials, leuprolide acetate achieves sustained suppression of serum testosterone to castration levels (≤50 ng/dl). The adverse-event profile is consistent with the effects of testosterone suppression. This novel delivery system in addition to the availability of a 6-month formulation of leuprolide acetate, offers patients the option of a convenient twice-yearly injection schedule.

Effects of testosterone suppression on serum levels of hepatitis B surface antigen and HBV-DNA in men.

There is epidemiological evidence that progression of hepatitis B virus (HBV)-induced liver disease is adversely influenced by male gender. Furthermore, in male transgenic mice, HBsAg levels increase after puberty, resulting in 4- to 10-fold higher HBsAg levels than in female transgenic mice. Castration reduces HBsAg levels by 90-95%, while substitution of testosterone to castrated animals rapidly increases HBsAg concentrations. We hypothesized that suppression of endogenous testosterone levels may have similar effects on HBsAg serum levels in men, as observed in male mice. To test our hypothesis, we studied the influence of reversible testosterone suppression by the LHRH-analog triptorelin on serum concentrations of HBsAg and HBV-DNA. Eight male patients, who were chronically infected with HBV, were studied in a prospective interventional study. Triptorelin decreased serum testosterone levels to castration levels for several weeks. However, this reversible testosterone suppression had no effect on HBsAg or HBV-DNA serum concentrations (p > 0.05). Suppression of endogenous testosterone levels had no effect on HBsAg levels in men, which points to a different regulation of HBsAg expression in men compared with transgenic mice.