NDLI: Clomiphene citrate for treatment of acromegaly not controlled by conventional therapies.

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Clomiphene citrate for treatment of acromegaly not controlled by conventional therapies.

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Clomiphene citrate for treatment of acromegaly not controlled by conventional therapies.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Duarte, Felipe H. Bronstein, Marcello D. Jallad, Raquel S.
Description	Country affiliation: Brazil Author Affiliation: Duarte FH ( Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clínicas, University of São Paulo Medical School, 05403-000 São Paulo, Brazil.)
Abstract	CONTEXT: Oral estrogens, alone or in combination with somatostatin receptor ligands, have been shown to control acromegaly in women. Selective estrogen receptor modulators resulted in similar effects in both genders. Clomiphene citrate (CC), a selective estrogen receptor modulator that increases LH and FSH secretion, improves hypogonadism and fertility outcomes. OBJECTIVE: To assess the impact of CC on serum IGF-1 and T levels in male acromegalic patients not controlled by surgery, radiotherapy, and/or medical treatment. STUDY DESIGN: In this prospective, open-label, single-center trial, CC (50 mg/d) was added to previous medical treatment for 3 months. Hormonal assessment was performed before and during the intervention. PATIENTS: Sixteen male patients (median age, 52.8 y; range, 36-79 y) met the following criteria: IGF-1 above the upper limit of normal range for at least 1 year despite the use of available medical therapies, and T levels within or below the third inferior tertile of normality. RESULTS: Serum IGF-1 levels decreased by 41% (mean ± SD, 424 ± 108 to 250 ± 83 ng/mL; P < .0004), leading 44% (seven of 16) of the patients to achieve normal IGF-1 levels. Total serum T levels increased by 209% (282 ± 201 to 497 ± 310 ng/dL), reaching normal levels in 67% (four of six) of those patients considered hypogonadal. CONCLUSIONS: Addition of CC should be considered an option in male acromegaly patients not controlled by current available options, with a considerable cost-saving benefit. Furthermore, improvement of T levels can be obtained in those patients with concurrent central hypogonadism.
ISSN	0021972X
e-ISSN	19457197
Journal	The Journal of Clinical Endocrinology & Metabolism
Issue Number	5
Volume Number	100
Language	English
Publisher	Oxford University Press
Publisher Date	2015-05-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Acromegaly Drug Therapy Clomiphene Therapeutic Use Hypogonadism Selective Estrogen Receptor Modulators Blood Insulin-like Growth Factor I Metabolism Prospective Studies Retreatment Testosterone Clinical Trial Discipline Endocrinology Discipline Metabolism
Content Type	Text
Resource Type	Article
Subject	Biochemistry (medical) Endocrinology, Diabetes and Metabolism Clinical Biochemistry Biochemistry Endocrinology

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