Discontinuous low-dose flutamide-metformin plus an oral or a transdermal contraceptive in patients with hyperinsulinaemic hyperandrogenism: normalizing effects on CRP, TNF-a and the neutrophil/lymphocyte ratio
Por:
Ibañez-Toda L, Valls C and de Zegher F
Publicada:
1 feb 2006
Resumen:
BACKGROUND: Low-dose flutamide-metformin (Flu-Met) with an oral contraceptive is a therapeutic option for women with hyperinsulinaemic hyperandrogenism. We questioned (i) whether Flu-Met maintains efficacy if given discontinuously; (ii) how the efficacy of discontinuous Flu-Met plus a transdermal contraceptive compares with Flu-Met plus oral contraceptive; and (iii) whether these treatments also lower circulating C-reactive protein (CRP) and tumour necrosis factor alpha (TNF-alpha) and the high neutrophil/lymphocyte ratio. METHODS: Non-obese, young patients (n = 31) with hyperinsulinaemic hyperandrogenism were started on Flu-Met (21/28 days) and randomized to receive in addition either a drospirenone oral contraceptive or a transdermal contraceptive for 6 months. RESULTS: The effects of Flu-Met were similar whether combined with oral or transdermal contraceptive. In both groups, CRP and TNF-alpha levels fell and the high neutrophil/lymphocyte ratio normalized (P < 0.001). Lean body mass increased (P < 0.001) in both groups but, in contrast to earlier experience with continuous Flu-Met, fat mass failed to decrease in either group. CONCLUSIONS: Flu-Met seems less lipolytic, if given for only 21 days in every 28-day period. The efficacy of Flu-Met is comparable when combined with an oral contraceptive or a transdermal contraceptive. The range of Flu-Met effects may henceforth include lower levels of CRP and TNF-alpha, and a normalization of the neutrophil/lymphocyte ratio.
Filiaciones:
Ibañez-Toda L:
Endocrinology Unit and Hormonal Laboratory, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Valls C:
Endocrinology Unit and Hormonal Laboratory, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
de Zegher F:
Endocrinology Unit and Hormonal Laboratory, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Univ Barcelona, Endocrinol Unit, Hosp Sant Joan Deu, Barcelona 08950, Spain
Univ Barcelona, Hormonal Lab, Hosp Sant Joan Deu, Barcelona 08950, Spain
Katholieke Univ Leuven, Dept Pediat, Louvain, Belgium
Univ Barcelona, Endocrinol Unit, Hosp Sant Joan Deu, Barcelona 08950, Spain
Univ Barcelona, Hormonal Lab, Hosp Sant Joan Deu, Barcelona 08950, Spain
Katholieke Univ Leuven, Dept Pediat, Louvain, Belgium
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