The spironolactone in relay of cyproterone acetate (Androcur) in the treatment of female hyperandrogenism: preliminary study in 37 patients
https://pepite-depot.univ-lille2.fr/nuxeo/site/esupversions/b172da0b-934f-4c3c-bbf6-9b3760e2d0ad
Summary: Context - Hyperandrogenia (HA) is a frequent reason for consultation in endocrine gynecology. It is defined by all symptoms due to excessive production of androgens. The main manifestations of HA are hirsutism, acne and androgen alopecia .
Cyproterone acetate (ACP)- Androcur is currently the first-line anti-Androgenic treatment. However, this treatment being controversial, Spironolactone (SLA) could be an effective alternative in ACP relay in the treatment of the female ha.
METHOD - This is a monocentric retrospective study carried out between December 2002 and January 2018 in the endocrine gynecology department of Jeanne de Flanders hospital at the Lille University Hospital. Patients with a clinical ha having benefited from treatment by ACP and then by SLA were included. In total, 37 patients benefited from a clinico-biological assessment before treatment, then under ACP and SLA.
RESULTS - On the clinical level, the vast majority of patients were satisfied with the relay not ALS and observed no difference between the two treatments. In biological level, testosterone and delta-4 Androstenedione levels were significantly reduced under ACP (p = 0.005 and p = 0.008) and SLA (p = 0.006 and p = 0.005) compared to the absence of treatment. There was no significant differences when compared the rates under ACP and SOU (p = 0.674 and p = 0.893). No significant difference has been highlighted for the plasma levels of other androgens as well as for FSH, LH and AMH. 87.5 % of patients were unharmed by side effects and only two patients mentioned menstrual cycle disorders. No serious side effects have been detected.
Conclusion - The data collected show a clinical efficiency of the ACP relay in the treatment of HA. In addition, biologically, testosterone and Delta-4 Androstenedione levels are significantly reduced in SLA compared to the absence of treatment and comparable to those obtained during ACP treatment. This anti-Androgen therefore appears as an effective and well tolerated alternative, in ACP relays in patients with HA. In all cases, the association of hygieno-dietetic and cosmetics measures with therapeutic management is necessary to improve its clinical manifestations.
Public database sheet, drug RCP: here
Note of the association: We must always discuss a new treatment and its possible side effects. The association has had negative feedback on this treatment (insomnia, heat puffs, heart problems, etc.). Far too many doctors still minimize the risks of Androcur ( while the epidemiological study is very real! ), And the risks of any medication elsewhere, saying that even paracetamol has side effects! However, certainly, paracetamol can kill, but not at therapeutic dose, but in overdose.
Would some doctors criticize patients for information, and simply ask them to follow the recommendations of the health authorities?
So to simply be aware of the benefit/risk balance and to inform the patients?
Cyproterone acetate (Androcur) always has a marketing authorization (AMM) for severe hirsutism seriously harming social life in women.
The spironolactone in relay of cyproterone acetate (Androcur) in the treatment of female hyperandrogenism: preliminary study in 37 patients
IMPORTANT
At our appointment at the October 2019 Cnam, we asked this question:
What management of severe hirsutism, when Androcur® (Cyproterone acetate) can no longer be prescribed?
A CNAM epility: Health insurance takes care, without request for a prior agreement, hair removal sessions with laser or flash lamp. Management is subject to the commitment of the doctor to respect the indication (in this case pathological hypertrichosis, confirmed and documented hirsutism ). The doctor translates this commitment by checking the RC box, and it is essential for reimbursement. The code to be used by the doctor is QZNP028, QZNP 029 or QZNP030 as a function of the surface treated with reimbursement bases ranging from 17.8 euros to 43.43 euros,
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