A comparison of the relative efficacy of antiandrogens for the treatment of acne in hyperandrogenic women

被引:39
作者
Carmina, E
Lobo, RA
机构
[1] Columbia Univ Coll Phys & Surg, Dept Obstet & Gynecol, New York, NY 10032 USA
[2] Univ Palermo, Dept Endocrinol, Palermo, Italy
关键词
D O I
10.1046/j.1365-2265.2002.01594.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES To compare the relative effectiveness of two newer antiandrogens (flutamide and finasteride) with cyproterone acetate (CPA), at both low and high doses in the treatment of moderate to severe acne in hyperandrogenic women. SUBJECTS AND DESIGN Forty-eight hyperandrogenic women were prospectively randomized to the following treatments for 1 year: CPA 2 mg with 35 mug ethinylestradiol; CPA 50 mg with 25 mug ethinylestradiol (reverse sequential regimen); flutamide 250 mg daily; and finasteride 5 mg daily. Assessment of Cook scores was the primary end-point of the trial. Blood for androgens was obtained at baseline in these women and 30 ovulatory age-matched controls. RESULTS Serum androgens were elevated in all 48 women and was similar in each of the four treatment groups. Cook scores were significantly and equally decreased (59-71%) with flutamide and both low and high doses of CPA (P < 0.01). The decrease with finasteride (-36 +/- 2%) was statistically significant but lower than that obtained with the other agents. All treatments were well tolerated. CONCLUSIONS In hyperandrogenic women with moderate to severe acne, low doses of certain antiandrogens appear to be effective. Low and high doses of CPA with ethinylestradiol were equally effective and were comparable to the effects of a low dose of flutamide. Finasteride was less beneficial.
引用
收藏
页码:231 / 234
页数:4
相关论文
共 26 条
[1]   CRYPROTERONE ACETATE FOR SEVERE HIRSUTISM - RESULTS OF A DOUBLE-BLIND DOSE-RANGING STUDY [J].
BARTH, JH ;
CHERRY, CA ;
WOJNAROWSKA, F ;
DAWBER, RPR .
CLINICAL ENDOCRINOLOGY, 1991, 35 (01) :5-10
[2]   Gonadotrophin-releasing hormone agonist therapy for hirsutism is as effective as high dose cyproterone acetate but results in a longer remission [J].
Carmina, E ;
Lobo, RA .
HUMAN REPRODUCTION, 1997, 12 (04) :663-666
[3]   EVIDENCE FOR INCREASED ANDROSTERONE METABOLISM IN SOME NORMOANDROGENIC WOMEN WITH ACNE [J].
CARMINA, E ;
LOBO, RA .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1993, 76 (05) :1111-1114
[4]   A risk-benefit assessment of pharmacological therapies for hirsutism [J].
Carmina, E .
DRUG SAFETY, 2001, 24 (04) :267-276
[5]  
CARMINA E, 1991, FERTIL STERIL, V55, P871
[6]  
CARMINA E, 2001, HIRSUTISM ALOPECIA A, P991
[7]   CYPROTERONE-ACETATE AND 2 DOSES OF ESTROGEN IN FEMALE ACNE - A DOUBLE-BLIND COMPARISON [J].
COLVER, GB ;
MORTIMER, PS ;
DAWBER, RPR .
BRITISH JOURNAL OF DERMATOLOGY, 1988, 118 (01) :95-99
[8]   ACNE GRADING METHOD USING PHOTOGRAPHIC STANDARDS [J].
COOK, CH ;
CENTNER, RL ;
MICHAELS, SE .
ARCHIVES OF DERMATOLOGY, 1979, 115 (05) :571-575
[9]   Treatment of hirsutism: comparisons between different antiandrogens with central and peripheral effects [J].
Fruzzetti, F ;
Bersi, C ;
Parrini, D ;
Ricci, C ;
Genazzani, AR .
FERTILITY AND STERILITY, 1999, 71 (03) :445-451
[10]   USE OF CYPROTERONE-ACETATE (CPA) IN TREATMENT OF ACNE, HIRSUTISM AND VIRILISM [J].
HAMMERSTEIN, J ;
MECKIES, J ;
LEOROSSBERG, I ;
MOLTZ, L ;
ZIELSKE, F .
JOURNAL OF STEROID BIOCHEMISTRY AND MOLECULAR BIOLOGY, 1975, 6 (06) :827-836