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How actual is the treatment with antiandrogen alone in patients with polycystic ovary syndrome?

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References

  1. Dunaif A., Givens J.R., Haseltine F., Merriam G.R. The polycystic Ovary Syndrome. Blackwell Scientific, Cambridge 1992.

    Google Scholar 

  2. Diamanti-Kandarakis E., Kouli Ch., Tsianateli Th., Zapanti E., Filandra F., Spina G., Bergiele A. A survey of PCOS in Greek population (metabolic and hormonal associations). Program of the 79th annual meeting of the Endocrine society Minneapolis, Minnesota, 1997 (Abstract 341).

  3. Diamanti-Kandarakis E., Dunaif A. New perspectives in polycystic ovary syndrome. Trends Endocrinol. Metab. 7: 267, 1996.

    Article  PubMed  CAS  Google Scholar 

  4. Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr. Rev. 18: 774, 1997.

    PubMed  CAS  Google Scholar 

  5. Dunaif A., Futterweit W., Segal K.R., Dobransky A. Profound peripheral insulin resistance, independent of obesity, in the polycystic ovary syndrome. Diabetes 38: 1165, 1989.

    Article  PubMed  CAS  Google Scholar 

  6. Ovesen R., Moller J., Ingerselev H.J., Jorgensen J.O.L., Mengel A., Schmitz Q., Alberti K.G.M.M., Moler N. Normal basal and insulin-stimulated fuel metabolism in lean women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 77: 1636, 1993.

    PubMed  CAS  Google Scholar 

  7. Toscano V., Bianchi P., Balducci R., Guglielmi R., Mangiantini A., Lubrano C., Sciarra F. Lack of linear relationship between hyperinsulinaemia and hyperandrogenism. Clin. Endocrinol. 36: 197, 1992.

    Article  CAS  Google Scholar 

  8. E. Diamanti-Kandarakis. The polycystic ovary syndrome: pathogenesis, metabolic implications, and therapeutic approach. Annals of the New York Academy of Sciences. Adolescent Gynecology and Endocrinology Basic and Clinical Aspects: 816: 177, 1997.

    CAS  Google Scholar 

  9. Velazquez E.M., Menoza S., Hamer T., Sosa F.&G., Lueck C.J. Metformin therapy in polycystic ovary syndrome reduces hyperinsulinemia, insulin resistance, hyperan-drogenemia and systolic blood pressure, while facilitang normal menses and pregnancy. Metabolism 43: 647, 1994.

    Article  PubMed  CAS  Google Scholar 

  10. Diamanti-Kandarakis E., Mitrakou A., Hennes M.M.I., Platanissiotis D., Kaklas N., Spina J., Georgiadou E., Hoffmann R.G., Kissebah A.H., Raptis S. Insulin sensitivity and antiandrogenic therapy in women with polycystic ovary syndrome. Metabolism 44: 525, 1995.

    Article  PubMed  CAS  Google Scholar 

  11. Diamanti-Kandarakis E., Kouli C., Tsianateli T., Bergiele A. Therapeutic effects of metformin on insulin resistance and hyperandrogenism in polycystic ovary syndrome. Eur. J. Endocrinol. 138: 269, 1998.

    Article  PubMed  CAS  Google Scholar 

  12. Moghetti P., Tosi F., Castello R., Magnani C.M., Negri C., Brun E., Furlani L., Caputo M., Muggeo M. The insulin resistance in women with hyperandrogenism is partially reversed by antiandrogen treatment: Evidence that androgens impair insulin action in women. J. Clin. Endocrinol. Metab. 81: 952, 1996.

    PubMed  CAS  Google Scholar 

  13. DeLeo V., Lanzetta D., D’Antona D., LAMarka A., Morgante G. Hormonal effects of flutamide in young women with polycystic ovary syndrome. J. Clin. Endocriol. Metab. 83: 99, 1998.

    Article  CAS  Google Scholar 

  14. Lobo R.A., Goebelsmann U., Horton R. Evidence for the importance of peripheral tissue events in the development of hirsutism in polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 57: 393, 1983.

    Article  PubMed  CAS  Google Scholar 

  15. Cusan L., Dupont A., Belanger A., Tremblay R.R., Manhes G., Labrie F. Treatment of hirsutism with the pure antiandrogen flutamide. J. Am. Acad. Dermatol. 23: 462, 1990.

    Article  PubMed  CAS  Google Scholar 

  16. Diamanti-Kandarakis E., Tolis G., Duleba A. Androgens and therapeutic aspects of antiandrogens in women. J. Soc. Gynecol. Invest. 2: 577, 1995.

    Article  CAS  Google Scholar 

  17. Gardiner P., Schrode K., Quinlan D., Martin B.K., Boreham D.R., Rogers M.S., Stubbs K., Smith M., Karim A. Spironolactone metabolism: Steady-state serum levels of the sulfur-containing metabolites. J. Clin. Pharmacol. 29: 342, 1989.

    Article  PubMed  CAS  Google Scholar 

  18. Schane H.P., Potts G.O. Oral progestational activity of spironolactine. J. Endocrinol. Metab. 47: 691, 1978.

    Article  CAS  Google Scholar 

  19. Levy J., Burshell A., Marbach M., Afilalo L., Glick S.M. Interaction of spironolactone with oestradiol receptors in cytosol. J. Endocrinol. 84: 371, 1980.

    Article  PubMed  CAS  Google Scholar 

  20. Menard R.H., Guenthner T.M., Kon H., Gillette J.R. Studies on the destruction of adrenal and testicular cytochrome P-450 by spironolactone. J. Biol. Chem. 254: 1726, 1979.

    PubMed  CAS  Google Scholar 

  21. Serafini P.C., Catelino J., Lobo R.A. The effect of spironolactone on genital skin 5 alpha-reductase activity. Steroid Biochem. 23: 191, 1985.

    Article  CAS  Google Scholar 

  22. Shapiro G., Evron S. A novel use of spironolactone: Treatment of hirsutism. J. Clin. Endocrinol. Metab. 51: 429, 1980.

    Article  PubMed  CAS  Google Scholar 

  23. Dorrington Ward P., McCartney A.C., Holland S., Scully J., Carter G., Alaghband-Zadeh J., Wise P. The effect of spironolactone in hirsutism and female androgen metabolism. Clin. Endocrinol. (Oxf.) 23: 161, 1985.

    Article  CAS  Google Scholar 

  24. Namer M. Clinical applications of antiandrogens. J. Steroid Biochem. 31: 719, 1988.

    Article  PubMed  CAS  Google Scholar 

  25. Messina M., Manieri C., Biffignandi P., Massucchetti C., Novi R.F., Molinatti G.M. Antiandrogenic properties of spironolactone. Clinical trial in the management of female hirsutism. J. Endocrinol. Invest. 6: 23, 1983.

    Article  PubMed  CAS  Google Scholar 

  26. Cumming D.C., Yang J.C., Rebar R.W., Yen S.S. Treatment of hirsutism with spironolactone. JAMA 247: 1295, 1982.

    Article  PubMed  CAS  Google Scholar 

  27. Ames R.P., Hill P. Raised serum lipid concentrations during diuretic treatment of hypertension: A study of predictive indexes. Clin. Sci. Mol. Med. Suppl. 4: 3115, 1978.

    Google Scholar 

  28. Cusan L., Dupont A., Gomez J.-L., Tremblay R.R., Labrie F. Comparison of flutamide and spironolactone in the treatment of hirsutism: A randomized controlled trial. Fertil. Steril. 61: 28, 1994.

    Google Scholar 

  29. Milewicz A., Silber D., Kirschner M.A. Therapeutic effects of spironolactone in polycystic ovary syndrome. Obstet. Gynecol. 61: 429, 1983.

    PubMed  CAS  Google Scholar 

  30. Nielsen P.G. Treatment of female acne vulgaris with a cream containing the antiandrogen canrenone. Dermatologica 166: 275, 1983.

    Article  PubMed  CAS  Google Scholar 

  31. Hammerstein J., Meckies J., Leo-Rossberg I., Moltz L., Zielske F. Use of cyproterone acetate (CPA) in the treatment of acne, hisrutism and virilism. J. Steroid. Biochem. 6: 827, 1975.

    Article  PubMed  CAS  Google Scholar 

  32. Belisle S., Love E.J. Clinical efficacy and safety of cyproterone acetate in severe hirsutism: results in a multicentered Canadian Study. Fertil. Steril. 46: 1015, 1986.

    PubMed  CAS  Google Scholar 

  33. Neumann F., Topert M. Pharmagology of antiandrogens. J. Steroid Biochem. 25: 885, 1986.

    Article  PubMed  CAS  Google Scholar 

  34. Lobl T.J., Cambell J.A., Tindall D.J., Cunningham G.R. Androgen antagonists in androgen target issues. Pharmacol. Ther. 24: 367, 1984.

    Article  PubMed  Google Scholar 

  35. Eil C., Edelson S.K. The use of human skin fibroblasts to obtain potency estimates of drug binding to androgen receptors. J. Clin. Endocrinol. Metab. 59: 51, 1984.

    Article  PubMed  CAS  Google Scholar 

  36. Humpel M., Wendt H., Schulze P.-E., Dogs G., Weiss C., Speck U. Bioavailability and pharmacokinetics of cyproteroneacetate after oral administration of 2.0 mg cyproterone acetate in combination with 50 µg ethinyloestradiol to 6 young women. Contraception 15: 579, 1977.

    Article  PubMed  CAS  Google Scholar 

  37. Eden J.A. The polycystic ovary syndrome presenting as resistant acne successfully treated with cyproterone acetate. Med. J. Aust. 155: 677, 1991.

    PubMed  CAS  Google Scholar 

  38. Golland I.M., Elstein M.E. Result of an open one-year study with Diane-35 in women with polycystic ovarian syndrome. Ann. NY Acad. Sci. 687: 263, 1993.

    Article  PubMed  CAS  Google Scholar 

  39. Greenwood R., Brummitt L., Burke B., Cunliffe W.J. Acne: Double blind clinical and laboratory trial of tetracycline, oestroge-cyproterone acetate, and combined treatment. Br. Med. J. (Clin. Res. Ed.) 291: 1231, 983.

  40. Lachnit-Fixon U. The development and evaluation of an ovulation inhibitor (Diane) containing an antiandrogen. Acta Obstet. Gynecol. Scand. (Sweden) 58: 33, 1979.

    Article  Google Scholar 

  41. Carlborg L. Cyproterone acetate versus levonorgestrel combined with ethinyl estradiol in the treatment of acne. Results of multicenter study. Acta Obstet. Gynecol. Scand. (Suppl.) 134: 29, 1986.

    Article  CAS  Google Scholar 

  42. Wishart J.M. An open study of triphasyl and Diane 50 in the treatment of acne. Australias J. Dermatol. 32: 51, 1991.

    Article  CAS  Google Scholar 

  43. Vermeulen A., Rubens R. Effects of cyproterone acetate plus ethinylestradiol low dose on plasma androgens and lipids in mildy hirsute or acneic young women. Contraception 38: 419, 1988.

    Article  PubMed  CAS  Google Scholar 

  44. Stivel M.S., Kauli R., Kaufman H., Laron Z. Adrenocortical function in children with precocious sexual development during treatment with cyproterone acetate. Clin. Endocrinol. 16: 163, 1982.

    Article  CAS  Google Scholar 

  45. Cusan L., Dupont A., Belanger A., Tremblay R.R., Manhes G., Labrie F. Treatment of hirsutism with the pure antiandrogen flutamide. J. Am. Acad. Dermatol. 23: 462, 1990.

    Article  PubMed  CAS  Google Scholar 

  46. Brogden R., Chrisp P. Flutamide. Drugs Aging 1: 104, 1991.

    Article  PubMed  CAS  Google Scholar 

  47. Schulz M., Schmoldt A., Donn F., Becker H. The pharmacokinetics of flutamide and its major metabolites after a single oral dose and during chronic treatment. Eur. J. Pharmacol. 34: 633, 1988.

    Article  CAS  Google Scholar 

  48. Diamanti E., Kaklas N., Georgiadou E., Spina J., Rangou D., Chlouverakis C. The impact of a pure antiandrogen on gonadotropin and prolactin secretion in women with PCO. Second International Capri Conference: Neuroendocrine and peripheral disorders of female reproductive system: Pathophysiologyandtherapies: May 22, Capri (Italy), 1992 Abstr. No 123.

  49. Mowszowicz I., Wright F., Vincens M., Rigaud C., Nahoul K., Mavier P., Guillemant S., Kuttenn F., Mauvais-Jarvis P. Androgen metabolism in hirsute patients treated with cyproterone acetate. J. Steroid Biochem. 20: 757, 1984.

    Article  PubMed  CAS  Google Scholar 

  50. Diamanti E., Kaklas N., Spina J., Georgiadou E., Rangou D., Chlouverakis K. Intraovarian regulators and polycystic ovarian syndrome. The effect of and androgen receptor blocker on gonadotropin release and androgen levels in PCO. Satellite symposium of the 9th International Congress of Endocrinology, Abstr. No 79, 1992.

  51. Kontula K.K., Seppanen P.J., van Duyne P., Bardin C.W., Janne O.A. Effect of a nonsteroidal antiandrogen, flutamide, on androgen receptor dynamics and ornithine decarboxylase gene expression in mouse kidney. Endocrinology 116: 226, 1985.

    Article  PubMed  CAS  Google Scholar 

  52. Balzano S., Cappa M., Migliari R., Scarpa R.M., Danielli E., Campus G., Pintus C., Sica V., Usai E., Martino E. The effect of flutamide and ACTH-stimulated plasma levels of adrenal androgens in patients with advanced prostate cancer. J. Endocrinol. Invest. 11: 693, 1988.

    Article  PubMed  CAS  Google Scholar 

  53. Diamanti-Kandarakis E., Mitrakou A., Raptis S., Tolis G., Duleba A. The effect of a pure antiandrogen receptor blocker, Flutamide, on the lipid profile in the polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 83: 2699–2705, 1998.

    Article  PubMed  CAS  Google Scholar 

  54. Wysowski D.K., Freiman J.P., Tourtelot J.B., Horton M.L. Fatal and non-fatal hepatotoxicity associated with flutamide. Ann. Intern. Med. 118: 860, 1993.

    Article  PubMed  CAS  Google Scholar 

  55. Rosman A.S., Frissora-Rodeo C., Marshal A.T., Reiter B.P. Cholestatic hepatitis following flutamide. Dig. Dis. Sci. 38: 1756, 1993.

    Article  PubMed  CAS  Google Scholar 

  56. Group TM-FS. One-year experience in the treatment of benign prostatic hyperplasia with finasteride. J. Androl. 12: 372, 1991.

    Google Scholar 

  57. Sciarra F., Toscano V., Concolino G., DiSilverio F. Antiandrogens: clinical applications. J. Steroid Biochem. Mol. Biol. (U.K) 37: 349, 1990.

    Article  CAS  Google Scholar 

  58. Vigersky R.A., Mehlman I., Glass A.R., Smith C.E. Treatment of hirsute women with cimetidite. N. Engl. J. Med. 303: 1042, 1980.

    Article  PubMed  CAS  Google Scholar 

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Diamanti-Kandarakis, E. How actual is the treatment with antiandrogen alone in patients with polycystic ovary syndrome?. J Endocrinol Invest 21, 623–629 (1998). https://doi.org/10.1007/BF03350788

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