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Background: Hypothyroidism can cause menstrual disturbances mainly oligoanovualtory cycles and sometimes menorrhagia. It has also been seen to cause subfertility and pregnancy related complications. Various studies have been done to evaluate gonadal dysfunctions in overt hypothyroidism but very few studies are there which have done using a gonadotrophin response in that subset of patients. Present study evaluates the response of leuprolide on gonadal functions of women with overt hypothyroidism in a tertiary care centre at Meerut.Methods: In this study 50 females of age 20 to 40 years with newly diagnosed overt hypothyroidism were taken as cases and age and Body Mass Index (BMI) matched healthy females were taken as controls. Both in cases and controls, basal FSH, LH, estradiol was measured on 2nd day to 5th day of menstrual cycle. Thereafter Leuprolide 20 mcg/kg was given subcutaneously on the same day. Post leuprolide test, stimulated LH, FSH and estradiol were measured. Basal and stimulated values were compared between both groups.Results: Basal LH was significantly higher in controls (8.2±3.2 mIU/L) when compared to cases (6.45±2.75 mIU/L) with a p value 0.03(<0.05). Basal estradiol and FSH levels were found to be nearly similar and non-significant in cases and controls. No significant differences were found between stimulated mean LH and estradiol in both the groups. Leuprolide response after stimulation test was found to be sluggish in patients with overt hypothyroidism compared to normal euthyroid controls. This study is the rare one done on human subject in tertiary care centre of India, however large sample and multicentric trials are necessary before establishing the biochemical results.Conclusions: Pituitary and gonadal (ovarian) response to leuprolide was found to have impaired (decreased) in overt hypothyroidism cases. This is the first study to be done in overt hypothyroid subjects to asses both basal and stimulated gonadotropin levels.
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Posterior reversible encephalopathy syndrome (PRES) is a newly described adverse effect possibly associated with gonadotropin-releasing hormone (GnRH) agonist therapy. We report a case of PRES after 2 doses of depot GnRH agonists in a 44-year-old woman with a huge myoma uteri and iron-deficiency anemia. Brain magnetic resonance imaging showed high signal lesions in both occipital lobes on fluid-attenuated inversion-recovery (FLAIR) images, compatible with PRES. After treatment with anticonvulsant, she recovered both radiographically and clinically. The association between PRES and GnRH agonist use is still enigmatic, and thus should be further clarified.
Subject(s)
Adult , Female , Humans , Anemia, Iron-Deficiency , Brain , Brain Diseases , Gonadotropin-Releasing Hormone , Leuprolide , Magnetic Resonance Imaging , Myoma , Occipital Lobe , Posterior Leukoencephalopathy Syndrome , UterusABSTRACT
BACKGROUND: This study examined the clinical effects of leuprolide acetate in sexual offenders with paraphilic disorders evaluated by means of objective psychiatric assessment. METHODS: The subjects of this study were seven sexual offenders who were being treated by means of an injection for sexual impulse control by a court order. They had been diagnosed with paraphilia by a psychiatrist based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) and had been put on probation by the Ministry of Justice between January 2016 and December 2016. RESULTS: After twelve months, we observed significant improvement in symptoms, as decrease of abnormal sexual interest and activity, sexual fantasy, Clinical Global Impression-Severity (CGI-S), and Clinical Global Impression-Impulsivity (GCI-I). There were a mild feminization of the body shape, feelings of fatigue, and mild hot flushes. No other adverse effect was reported. CONCLUSION: These results suggested that the clinical effects of leuprolide acetate in sexual offenders might be an effective treatment and safety strategy.
Subject(s)
Humans , Criminals , Diagnostic and Statistical Manual of Mental Disorders , Fantasy , Fatigue , Feminization , Leuprolide , Paraphilic Disorders , Psychiatry , Sexual Behavior , Social Justice , Therapeutic UsesABSTRACT
Objetivo: Comparar los protocolos de microdosis de acetato de leuprolide y priming de estradiol. Métodos: Estudio retrospectivo de 115 pacientes bajas respondedoras (según criterios de Bologna), evaluadas en UNIFERTES desde enero 2010 a diciembre 2012, sometidas a hiperestimulación ovárica controlada según protocolo. La inducción ovárica constó de pauta fija con gonadotropinas (hormona folículo estimulante recombinante 450 UI/día + Gonadotropina menopaúsica humana 150 UI/día); realizando disparo de ovulación con 10.000 UI gonadotropina coriónica humana urinaria al obtener 2 o 3 folículos entre 17-18 mm de diámetro. Se realizó aspiración folicular con aguja bilumen a las 35 horas del disparo, fecundación in vitro en medios secuenciales y transferencia embrionaria al día 3. El soporte de fase lútea constó de progesterona natural micronizada 600 mg/día y valerato de estradiol 4 mg/día. Se realizó prueba de embarazo cuantitativa a los quince días y verificación de embriocardia al mes. Se compara: tasa de cancelación, días de estimulación, número de ovocitos aspirados, tasa de embarazo clínico por transferencia y tasa de aborto. Resultados: Se incluyeron 115 pacientes: 69 al protocolo de microdosis y 46 al de priming de estradiol. No hubo diferencias estadísticas entre ambos protocolos en cuanto a: número de ovocitos aspirados, tasa de embarazo clínico y aborto. Los días de estimulación y la dosis total de gonadotropinas fue mayor con microdosis. Conclusiones: Aunque no hubo diferencias estadísticamente significativas entre ambos protocolos, el de priming de estradiol por tener menos días de estimulación y dosis totales de gonadotropinas menores, implica mayor bienestar de la paciente.
Objective: To compare microdose leuprolide acetate protocols and Estradiol Priming. Methods: Retrospective study of 115 low-responding patients (according to Bologna Criteria), evaluated at UNIFERTES from January 2010 to December 2012, who underwent controlled ovarian hyperstimulation as per Microdose leuprolide acetate protocol or Estradiol Priming Protocols. Ovarian induction consisted of a set standard with gonadotropins, 450UI/day recombinant follicle-stimulating hormone + 150UI/day Human Menopausal Gonadotropin; performing an ovulation trigger shot with 10,000UI urinary human chorionic gonadotropin when obtaining 2 to 3 follicles of 17-18mm diameter. Follicular aspiration is performed with double lumen needle, 35 hours from trigger shot with in vitro fertilization in sequential media, and embryo transfer on day 3. Luteal phase support consisted of 600mg/day micronized natural progesterone and 4mg/day of estradiol valerate. Quantitative pregnancy test was carried out at fifteen days and embryo cardiac activity validation at one month. The following are compared: cancellation rate, stimulation days, number of aspirated oocytes, rate of clinical pregnancy by transfer and abortion rate. Results: 115 patients were included: 69 underwent microdose leuprolide acetate protocol flare and 46 underwent estradiol priming. There were no statistical differences between both protocols with regards to: number of aspirated oocytes, rate of clinical pregnancy by transfer and abortion rate. Stimulation days and therefore, gonadotropins total dosage was greater with microdose leuprolide acetate protocol. Conclusions: Even though there were no significant statistical differences between both protocols, estradiol priming entails greater patients wellbeing, since it requires less stimulation days and less gonadotropin total dosages.
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Objective To investigate the clinical effect of laparoscopy combined with leuprolide on patients with mild endometriosis and infertility and effects on fertility function of patients. Methods A total of 60 patients with mild endometriosis and infertility in our hospital were randomly divided into the control group (n=30) and the observation group (n=30). The control group was treated with laparoscopic surgery, the observation group was treated with leuprorelin treatment, and the levels of FSH, E2, luteinizing hormone and PROG were tested by automatic biochemical analyzer between two groups before and after treatment, the pregnancy rate as assessment of reproductive function in patients. Clinical curative effect and effect on fertility of 2 groups were compared. Results Levels of FSH, E2, LH and PROG in the observation group were lower than those in the control group (P<0.05) in 3 months after treatment, and the pregnancy rates in the observation group after 1 months, 2 months and 3 months were higher than that in the control group (P<0.05). Conclusion The treatment of Laparoscopy combined with Leuprolide for mild endometriosis and infertility in patients has ideal effect, and is worthy of popularization and application.
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Objective To establish a determination method for leuprolide acetate microspheres. Methods HPLC was performed on Inertsil ODS-SP (150×4.6 mm×5μm) with mobile phase consist of 0.1 mol/L of Ammonium Dihydrogen Phosphate(adjust its pH to 7.00±0.05 with Ammonium Hydroxide) and Acetonitrile in ratio of 3:1(V/V),and the flow rate was 1.0 mL/min.The wavelength was 220 nm and column temperature was 30℃. The injection volume was 20 μL. Results The linear range of leuprolide acetate was 20.0-160.0μg/mL (r=0.9999) with an average recovery of 99.80%,RSD=0.63%(n=9). Conclusion The method of HPLC was accurate,reliable and specific, which could be used to determinate the assay of leuprolide acetate microspheres and for quality control of microspheres.
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Objective To explore the clinical efficacy of Danzhi Xiaoyao capsule combined with leuprolide acetate for treatment of central precocious puberty(CPP) in children.Methods One hundred and six female children with CPP in Xinyang Central Hospital from March 2015 to December 2016 were selected and divided into control group and observation group by random digits table,with 53 children in each group.The children in the control group were given leuprolide acetate subcutaneously;based on this,the children in the observation group were given Danzhi Xiaoyao capsule.After treatment,the ovarian volume,uterine volume,bone age index,sex hormone,height change,clinical efficacy and adverse reactions of children were compared between the two groups.Results Before treatment,there was no statistic difference in the ovarian volume,uterine volume and bone age index of children between the two groups (P ＞ 0.05);the ovarian volume,uterine volume and bone age index of children in the two groups after treatment were significantly lower than those before treatment (P ＜ 0.05);the ovarian volume,uterine volume and bone age index of children in the observation group were significantly lower than those in the control group (P ＜ 0.05).Before treatment,there was no statistic difference in the luteotropic hormone (LH),follicle-stimulating hormone (FSH) and estradiol(E2) levels of children between the two groups (P ＞ 0.05);the LH,FSH and E2 levels of children in the two groups after treatment were significantly lower than those before treatment (P ＜ 0.05);the LH,FSH and E2 levels of children in the observation group were significantly lower than those in the control group (P ＜ 0.05).The height growth speed of children in observation group [(4.52 + 0.83) cm · a-1] was significantly lower than that in control group [(7.35 ± 1.02) cm · a-1] (P ＜ 0.05).The total effective rate of children in observation group (92.45％) was significantly higher than that of control group (73.58％) (x2 =6.692,P ＜ 0.05).There was no adverse effects in the two groups during treatment.Conclusion Danzhi Xiaoyao capsule combined with leuprolide acetate for treatment of central precocious puberty in children has evident effect,less adverse reactions;it can effectively regulate the sex hormones levels of body,and delay the growth time.
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Objective:To study the effect of leuprolide preoperative used in the patients with uterine fibroids .Methods:Totally 70 patients with uterine fibroids were divided into the observation group and the control group with 35 ones in each.The 35 patients in the control group were with laparoscopic myomectomy , and those in the observation group was given leuprolide , 3.75 mg per time, once in a month for 3 months, and then undergone laparoscopic myomectomy .The serum hormone levels , menstruation situation and fi-broids and uterus volume changes in the observation group were observed and compared before the treatment and after the 3-month leu-prolide treatment .The situation during the operation and after the operation , and the recurrence rate of uterine fibroids between the two groups were compared .Results:After the pretreatment of leuprolide , the levels of luteinizing hormone ( LH) , follicle-stimulating hor-mone (FSH) and serum estradiol (E2) in the observation group were significantly lower than those before the treatment (P<0.05), and the menstrual blood volume , uterine volume and fibroid volume were significantly lower than those before the treatment , and the differences were statistically significant (P<0.05).The blood loss during the operation and pelvic drainage of the observation group were significantly lower than those of the control group , and the ambulation time and length of hospital stay of the observation group were significantly shorter than those of the control group with statistically significant differences (P<0.05).Conclusion:Leuprolide preoperative used in the patients with uterine fibroids can significantly reduce serum hormone levels and fibroid volume , which are ben-eficial to myomectomy with smaller surgery invasion and better prognosis .
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OBJECTIVE:To discuss clinical efficacy and safety of leuprolide acetate in the treatment of endometriosis. METH-ODS:66 endometriosis patients were divided into observation group(37 cases)and control group(29 cases)according to random number table method. Observation group was treated with Leuprolide acetate microsphere for injection,3.75 mg/time,on the upper arm,abdomen or buttocks since the first-fifth day of menstrual cycle(administration time was available at hysterectomized patients disposal),and then every 4 weeks;one administration was recognized as a treatment course. Control group was treated with Ethi-nyl estradiol cyproterone tablet orally,1 tablets per day for 3 weeks,one week drug withdrawal,as a treatment course. 2 groups were given 3-5 courses of treatment according to their tolerance or the improvement of clinical symptoms. The improvement of clini-cal symptoms were compared between 2 groups,and the levels of FSH,LH and E2 were compared before and after treatment;the occurrence of ADR and the time of the return of menses were recorded. RESULTS:2 patients in observation group and 1 patient in control group withdrew from the test. After treatment,total effective rate was 97.14% in observation group,which was significant-ly higher than 75.00% in control group,with statistical significance (P0.05). After treatment,the levels of FSH,LH and E2 were de-creased significantly,and the observation group was more significant than the control group,with statistical significance (P0.05). The time of the return of menses in observation group was (89.75 ± 3.34) d after drug withdrawal,com-pared to control group [(88.46±2.94)d],there was no statistical significance(P>0.05). CONCLUSIONS:Leuprolide acetate can effectively improve clinical symptoms of patients with endometriosis,and reduce the levels of FSH,LH and E2 with slight ADR, and it doesn’t influence the time of the return of menses.
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OBJECTIVE:To observe the efficacy and safety of Guizhi fuling capsule combined with leuprolide acetate in the treatment of endometriosis (EMS) after laparoscopicsurgery. METHODS:87 EMS patients were randomly divided into control group(44 cases)and observation group(43 cases). Control group received EMS resection under laparoscope,3.75 mg Leuprolide acetate for injection was given in the first day of postoperative first menstruation by intramuscular injection,once a day. Observa-tion group additionally received 0.93 g Guizhi fuling capsule,3 times a day. The treatment course for both groups was 6 months. Clinical efficacy,estradiol(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH)and prolactin(PRL)levels before and after treatment,recurrence after 6 months and the incidence of adverse reactions in 2 groups were observed. RESULTS:The to-tal effective rate in observation group was significantly higher than control group,recurrence rate was significantly lower than con-trol group,the differences were statistically significant (P0.05);after treatment,E2,FSH,LH and PRL in 2 groups were significantly lower than be-fore,and E2,FSH and LH in observation group were lower than control group,the differences were statistically significant (P0.05). And there was no significant difference in the inci-dence of adverse reactions in 2 groups (P>0.05). CONCLUSIONS:After laparoscope resection,Guizhi fuling capsule combined with leuprolide acetate can effectively improve efficacy,reduce sex hormone level and recurrence rate,and do not increase the inci-dence of adverse reactions in the treatment of EMS.
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A phospholipid-based injectable gel was developed for the sustained delivery of leuprolide acetate (LA). The gel system was prepared using biocompatible materials (SPME), including soya phosphatidyl choline (SPC), medium chain triglyceride (MCT) and ethanol. The system displayed a sol state with low viscosity in vitro and underwent in situ gelation in vivo after subcutaneous injection. An in vitro release study was performed using a dialysis setup with different release media containing different percentages of ethanol. The stability of LA in the SPME system was investigated under different temperatures and in the presence of various antioxidants. In vivo studies in male rats were performed to elucidate the pharmacokinetic profiles and pharmacodynamic efficacy. A sustained release of LA for 28 days was observed without obvious initial burst in vivo. The pharmacodynamic study showed that once-a-month injection of LA-loaded SPME (SPME-LA) led to comparable suppression effects on the serum testosterone level as observed in LA solution except for the onset time. These findings demonstrate excellent potential for this novel SPME system as a sustained release delivery system for LA.
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Leuprolide acetate is an established luteinizing hormone-releasing hormone (LHRH) agonist used as a first-line treatment in advanced prostate cancer. An 80-year-old man presented with a localized erythematous patch with an indurated plaque and nodule and pustules on the left upper arm. The patient had been treated for metastatic prostate cancer with subcutaneous injections of leuprolide acetate 18 months previously. Histopathologic findings revealed granulomas with multinucleated giant cells from the dermis to the subcutaneous fat layer. The granuloma contained numerous round vacuoles. Cultures from the tissue for bacteria, fungi, and mycobacteria were all negative. The diagnosis of leuprolide acetate-induced foreign body granuloma was made by clinicopathologic findings. Various theories on the mechanism of local reactions to leuprolide have been suggested. The formation of granulomas may be related to the poly (lactic-co-glycolic acid) polymers or leuprolide itself. The depth of injection could have also contributed; therefore, intramuscular injection is recommended to minimize granuloma formation. To the best of our knowledge, there has been no reported case of leuprolide-induced foreign body granuloma in a patient with prostate cancer in the Korean literature. Dermatologists need to know that leuprolide acetate depot injection may cause a granulomatous reaction.
Subject(s)
Aged, 80 and over , Humans , Arm , Bacteria , Dermis , Diagnosis , Foreign Bodies , Fungi , Giant Cells , Gonadotropin-Releasing Hormone , Granuloma , Granuloma, Foreign-Body , Injections, Intramuscular , Injections, Subcutaneous , Leuprolide , Polymers , Prostate , Prostatic Neoplasms , Subcutaneous Fat , VacuolesABSTRACT
Leuprolide acetate is an established luteinizing hormone-releasing hormone (LHRH) agonist used as a first-line treatment in advanced prostate cancer. An 80-year-old man presented with a localized erythematous patch with an indurated plaque and nodule and pustules on the left upper arm. The patient had been treated for metastatic prostate cancer with subcutaneous injections of leuprolide acetate 18 months previously. Histopathologic findings revealed granulomas with multinucleated giant cells from the dermis to the subcutaneous fat layer. The granuloma contained numerous round vacuoles. Cultures from the tissue for bacteria, fungi, and mycobacteria were all negative. The diagnosis of leuprolide acetate-induced foreign body granuloma was made by clinicopathologic findings. Various theories on the mechanism of local reactions to leuprolide have been suggested. The formation of granulomas may be related to the poly (lactic-co-glycolic acid) polymers or leuprolide itself. The depth of injection could have also contributed; therefore, intramuscular injection is recommended to minimize granuloma formation. To the best of our knowledge, there has been no reported case of leuprolide-induced foreign body granuloma in a patient with prostate cancer in the Korean literature. Dermatologists need to know that leuprolide acetate depot injection may cause a granulomatous reaction.
Subject(s)
Aged, 80 and over , Humans , Arm , Bacteria , Dermis , Diagnosis , Foreign Bodies , Fungi , Giant Cells , Gonadotropin-Releasing Hormone , Granuloma , Granuloma, Foreign-Body , Injections, Intramuscular , Injections, Subcutaneous , Leuprolide , Polymers , Prostate , Prostatic Neoplasms , Subcutaneous Fat , VacuolesABSTRACT
La apoplejía tumoral pituitaria es un síndrome infrecuente que resulta del infarto y/o hemorragia espontánea de un adenoma pituitario preexistente. Ya que el evento primario involucra el adenoma, este síndrome debe ser nombrado como apoplejía tumoral pituitaria y no como apoplejía pituitaria. El aumento súbito en la presión de los contenidos de la silla turca da como resultado una cefalea de inicio agudo (puede ser incluso una "cefalea en trueno") de intensidad severa, alteraciones visuales y compromiso en la función pituitaria. El diagnóstico se basa en una alta sospecha clínica, imagen por resonancia magnética y medición de hormonas hipofisiarias en sangre. El tratamiento se basa en medidas de soporte (líquidos intravenosos y corticoides) y en casos sin buena respuesta o con deterioro neurológico, descompresión de silla turca. A continuación presentamos el caso de un adenoma previamente no diagnosticado que debutó como apolejía tumoral pituitaria. (Acta Med Colomb 2015; 40: 249-253).
Pituitary tumor apoplexy is an infrequent condition resulting from infarction and/or spontaneous bleeding from a pre-existing pituitary adenoma. This entity requires the prior existence of an adenoma in order to be named as pituitary tumor apoplexy, otherwise, it should be named pituitary apoplexy. The sudden increase in pressure of the sella turcica's contents results in a clinical syndrome characterized by headache (which can be "thunderclap headache"), visual disturbances and hypopituitarism. Diagnosis is not always straight forward and requires high clinical suspicion in addition to magnetic resonance imaging and measurement of serum pituitary hormones. Treatment is mainly based on supportive measures (intravenous fluids and steroids) and surgical decompression in those cases with no response to medical treatment and progressive neurological impairment. We report the case of a patient with a previously unknown pituitary adenoma presenting as a tumor apoplexy. (Acta Med Colomb 2015; 40: 249-253).
Subject(s)
Humans , Middle Aged , Pituitary Apoplexy , Magnetic Resonance Imaging , Adenoma , Ophthalmoplegia , Leuprolide , Adrenal Insufficiency , Diplopia , Headache , Hemorrhage , HypopituitarismABSTRACT
Objective To evaluate the effectiveness and safety of leuprolide acetate in the treatment of endometriosis. Methods From Nov. 2007 to Oct. 2012, the patients who confirmed to be endometriosis were randomly divided into test group of 113 cases and control group of 116 cases. The test drug was the sustained-release agent of leuprolide acetate. The control drug was Enantone. The drugs were used for 3 times in total. After treatment, the ovarian mass volumes measured with type-B ultrasound, the scores of the patient′s subjective symptoms during non-menstrual and menstruation days, the pelvic signs during non-menstrual days, the changes of hormones [estradiol (E2), FSH, LH], and adverse events were observed. Results After the treatment, the rate of changes of ovarian mass volume (among them, at 12 weeks after the first injection, the median was -55.83% in the test group, -68.22% in the control group, P=0.336), the distinct improvement rate of symptom scores and pelvic signs during non-menstrual days [among them, at 12 weeks after the first injection, the rate of lower abdomen pain was 47.5%(48/101) in the test group, 44.0%(44/100) in the control group, P=0.881], the hormone (E2, FSH, LH) levels [among them, at 12 weeks after the first injection, the serum level of E2, was (33±38) pmol/L in the test group, (38± 40) pmol/L in the control group, P=0.414;the serum level of FSH, was (5.1±2.8) U/L in the test group, (5.3± 2.3) U/L in the control group, P=0.666;the serum level of LH, was (0.6±0.8) U/L in the test group, (0.6±0.9) U/L in the control group, P=0.907], had no statistically significant difference between the two groups (all P>0.05). The distinct improvement rate and improvement rate of symptom (lower abdomen pain, low back pain) scores during menstruation days at 12 weeks after the first injection, the rates of lower abdomen pain were 73.9%(34/46), 15.2%(7/46) respectively in the test group, 72.3%(34/47), 2.1%(1/47) respectively in the control group, had statistically significant difference between the two groups (P=0.026). There was no serious adverse event occurred in both two groups. The incidence rate of adverse event was 33.6%(38/113) in test group, 23.2% (27/116) in control group, there was no significant difference between the two groups (P=0.082). Conclusion Leuprolide acetate is effective and safe in the treatment of endometriosis.
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Objective To investigate the efficiency and safety of self-made Neiyixiao decoction combined with leuprorelin in patients with endometriosis (EMs). Methods A total of 82 patients with EMs were randomly recruited into a treatment group and a control group, with 41 patients in each group. The treatment group was treated with self-made Neiyixiao decoction combined with leuprorelin, and the control group was treated with leuprorelin only. The serum levels of CA125 and RANTES were detected with enzyme-linked immunosorbent assay. The symptoms and signs scores for pelvic endometriosis were evaluated before and after the treatment. Results The symptoms scores (0.4 ± 0.2 vs. 0.6 ± 0.3;t=3.552, P=0.001) and the signs scores (0.8 ± 0.4 vs. 1.1 ± 0.6;t=2.664, P=0.009) for pelvic endometriosis after the treatment in the treatment group were significantly lower than those in the control group. The serum levels of CA125 (26.4 ± 11.9 U/ml vs. 33.9 ± 12.8 U/ml; t=2.012, P=0.048) and RANTES (34.3 ± 14.1 ng/L vs. 43.7 ± 16.8 ng/L;t=2.744, P=0.008) after the treatment in the treatment group were significantly lower than those in the control group. The total effective rate in the treatment group was significantly higher than that in the control group (90.2%vs. 73.2%;χ2=3.998, P=0.046), and the rate of adverse reaction significantly lower (7.3%vs. 24.4%;χ2=4.479, P=0.034). The recurrence rate in the treatment group was significantly lower than that in the control group (16.2%vs. 46.7%;χ2=5.954, P=0.015) during 12 months of follow-up. Conclusion Self-made Neiyixiao decoction combined with leuprorelin can decrease serum levels of CA125 and RANTES, alleviate symptoms and signs, and its efficiency and safety are superior to leuprorelin alone in patients with endometriosis.
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Introdução: O acetato de leuprorrelina, substância ativa do medicamento Eligard®, é um análogo sintético não peptídeo do hormônio liberador do hormônio luteinizante (LHRH) que está bem estabelecido para o tratamento de primeira linha para pacientes com câncer de próstata avançado. Diversas opções de análogos LHRH estão disponíveis no Brasil, com diferentes formulações e periodicidade entre as aplicações. O Eligard® 45mg, de administração semestral, pode trazer vantagens clínicas e econômicas pela sua maior duração de efeito. Objetivo: Realizar uma avaliação econômica comparando diferentes apresentações de Eligard® e outros análogos LHRH no tratamento de pacientes com câncer de próstata avançado ou metastático no Brasil, sob as perspectivas do SUS, serviços públicos e saúde suplementar. Método: Modelos de Markov foram desenvolvidos para avaliar custos e desfechos em coortes de pacientes com câncer de próstata metastático, sem tratamento prévio, submetidos à terapia de privação androgênica e tratamentos subsequentes. Eligard® 45 mg, em sua forma de depósito semestral, foi colocado em perspectiva econômica com outras seis apresentações de análogos de LHRH disponíveis no mercado nacional. Resultados: O bloqueio androgênico, com qualquer um dos análogos LHRH avaliados, resultou em uma expectativa de vida média de 31,44 meses em todas as perspectivas analisadas...
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Humans , Economics, Pharmaceutical , Gonadotropin-Releasing Hormone , Prostatic NeoplasmsABSTRACT
Objective To explore the clinical effects of laparoscopic surgery combined with marvelon,gestrinone and leuprolide in treatment of chronic endometriosis.Methods 50 cases of endometriosis were collected.They were randomly divided into observation group and control group,each group having 25 cases.The control group underwent laparoscopic surgery and the observation group underwent laparoscopic surgery combined marvelon,gestrinone and leuprolide for 3 months.The two groups were compared in clinical effects,recurrence and pregnancy rate,as well as the operation situation.Results The effective rate was 92.0％ (23/25) in the observation group and 64.0％ (16/25) in the control group.The effective rate of observation group was obviously higher than that of the control group(P ＜ 0.05).The recurrence rate was 8.0％ (2/25)in the observation group,and 32.0％ (8/25) in the control group.The recurrence rate of combination group was obviously lower than that of the simple surgical group(P ＜ 0.05).The pregnancy rate was 80.0％ in the observation group;and 48.0％ in the control group after treatment.The pregnancy rate of the observation group was obviously higher than that of the control group(P ＜ 0.05).Liver damage or other adverse reactions didn't occur to any group after the treatment.The mean time of leaving bed was (1.4 ± 0.4) d after operation in the observation group vs (3.6 ± 1.5) d after operation in the control group.Length of hospital stay was (7.6 ± 3.5) d in the observation group vs (11.5 ± 3.9) d in the control group.The difference had statistical significance(all P ＜ 0.05).Conclusions Laparoscopic surgery combined with marvelon,gestrinone and leuprolide is superior to pure surgery group in treatment of endometriosis.It can improve the effective and pregnancy rate,and reduce the recurrence rate.No obvious adverse reactions can be found,thus it is worth of clinical promotion.
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PURPOSE: Long-acting gonadotropin-releasing hormone agonists (GnRHa) are commonly used to treat central precocious puberty (CPP) in Korea. Although rare, there have been reports on the characteristic of adverse reactions of GnRHa in CPP among the Korean population. This study was intended to report on our clinical experience regarding significant adverse reactions to long-acting GnRHa in CPP and early onset puberty and to evaluate the prevalence rate of serious side effects. METHODS: This retrospective study included children with CPP and early onset puberty, who were administered monthly with long-acting GnRHa (leuprolide acetate, triptorelin acetate) at the outpatient clinic of Department of Pediatrics, at Inha University Hospital, between January 2011 and December 2013. We analyzed the clinical characteristics of patients who experienced significant adverse reactions and evaluated the prevalence rate. RESULTS: Six serious side effects (0.9%) were observed among total of 621 CPP and early onset puberty children with GnRHa therapy. The number of sterile abscess formation was four in three patients (4 events of 621). Anaphylaxis occurred in only one patient, and unilateral slipped capital femoral epiphysis (SCFE) in another one patient. Anaphylaxis occurred after the 6th administration of the monthly depot triptorelin acetate. Unilateral SCFE developed in GnRHa therapy. CONCLUSION: Sterile abscess formation occurred in 0.6% of CPP and early onset puberty patients from the administration of a monthly depot GnRHa therapy. The occurrences of anaphylaxis and SCFE are extremely rare, but can have serious implications on patients. Clinicians should be aware of these potential adverse effects related to GnRHa therapy in CPP.