| [PMID]: | 26176805 |
| [Au] Autor: | Helo S; Ellen J; Mechlin C; Feustel P; Grossman M; Ditkoff E; McCullough A |
| [Ad] Endereço: | Albany Medical Center, Division of Urology, Albany, NY, USA. |
| [Ti] Título: | A Randomized Prospective Double-Blind Comparison Trial of Clomiphene Citrate and Anastrozole in Raising Testosterone in Hypogonadal Infertile Men. |
| [So] Source: | J Sex Med;12(8):1761-9, 2015 Aug. |
| [Is] ISSN: | 1743-6109 |
| [Cp] País de publicação: | Netherlands |
| [La] Idioma: | eng |
| [Ab] Resumo: | AIM: Clomiphene citrate (CC) and anastrozole (AZ) have been used off label to increase testosterone (T) in hypogonadal infertile men (HIM). Both medications have been shown to increase T with different effects on estradiol (E2) and T-to-E2 ratios. There are no reported randomized trials comparing CC and AZ to improve T levels in HIM. We aimed to establish equivalence of CC vs. AZ with respect to improvement in T levels in HIM. METHODS: We randomized 26 HIM (T less than 350 ng/dL and normal luteinizing hormone [LH]). Patients were randomized to CC (25 mg/day) or AZ (1 mg/day) for 12 weeks. Hormones assayed were total T, free T, E2, LH, follicle stimulating hormone (FSH), and sex hormone binding globulin (SHBG). Patient-reported outcomes were the International Index of Erectile Function, Erection Hardness Scale, and the Androgen Deficiency in the Aging Male questionnaires. Blood tests and questionnaires were recorded at baseline, 6 and 12 weeks. Semen analyses were performed at baseline and 12 weeks. RESULTS: T increased significantly from baseline in both groups at 6 and 12 weeks. There was a significantly larger increase in T and mean increase from baseline in CC vs. AZ (571 vs. 408 ng/dL, respectively). Whereas E-2 levels increased in the CC group, they decreased in the AZ group. Though both groups demonstrated an increase in T-to-E-2 ratio from baseline, statistic significance at 6 and 12 weeks was only achieved with AZ. Neither group demonstrated significant changes in seminal parameters or patient-reported outcomes. CONCLUSIONS: We failed to demonstrate equivalence of CC vs. AZ. CC resulted in significantly higher T levels than AZ. AZ resulted in a significantly larger increase in T/E-2 ratio than CC. No significant differences between CC and AZ on seminal parameters or patient-reported outcomes were demonstrated. |
| [Mh] Termos MeSH primário: |
Clomifeno/uso terapêutico
Fármacos para a Fertilidade Masculina/uso terapêutico
Hipogonadismo/tratamento farmacológico
Infertilidade Masculina/tratamento farmacológico
Nitrilos/uso terapêutico
Testosterona/sangue
Triazóis/uso terapêutico
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| [Mh] Termos MeSH secundário: |
Método Duplo-Cego
Hormônio Foliculoestimulante/sangue
Hormônios/uso terapêutico
Seres Humanos
Hipogonadismo/sangue
Hormônio Luteinizante/sangue
Masculino
Estudos Prospectivos
Testosterona/deficiência
Resultado do Tratamento
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| [Pt] Tipo de publicação: | COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL |
[Nm] Nome de substância:
| 0 (Fertility Agents, Male); 0 (Hormones); 0 (Nitriles); 0 (Triazoles); 1HRS458QU2 (Clomiphene); 2Z07MYW1AZ (anastrozole); 3XMK78S47O (Testosterone); 9002-67-9 (Luteinizing Hormone); 9002-68-0 (Follicle Stimulating Hormone) |
| [Em] Mês de entrada: | 1602 |
| [Cu] Atualização por classe: | 161209 |
[Lr] Data última revisão:
| 161209 |
| [Sb] Subgrupo de revista: | IM |
| [Da] Data de entrada para processamento: | 150716 |
| [St] Status: | MEDLINE |
| [do] DOI: | 10.1111/jsm.12944 |
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