By Louis Denis (auth.), Professor Dr. Louis Denis (eds.)

The creation of maximal androgen blockade as a scientific treatment by means of Brachi and Labrie greater than a decade in the past resulted in a major controversy at the medical use of antiandrogens within the remedy of prostate melanoma. 3 consensus conferences have been as a result prepared with the aid of the yank melanoma Society, the Urological crew of the eu association for learn and therapy of melanoma and the overseas Prostate overall healthiness Council. the 1st result of the meta-analysis of twenty-two trials didn't placed an finish to the talk, notwithstanding, and clinicians have been left burdened via conflicting reviews released by way of dozens of specialists. The assembly in the back of the current quantity created a discussion board for the scientists who constructed the medication and expert clinicians to supply a consensus. the result's an summary of the sphere, condensed from 1000s of courses. the data has been up to date to supply unique medical symptoms for using antiandrogens together remedies and monotherapy for the person sufferer. we are hoping that this staff attempt will facilitate ongoing discussions and result in stronger sufferer care in addition to elevated wisdom of the medicine which are so important to our sufferers' caliber of lifestyles and survival.

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Thus CPA and similar antiandrogens display only some of the typical effects of glucocorticoids. No sign of secondary adrenal insufficiency has been seen in any study. In clinical use, glucocorticoid effects become manifest only during high-dose (more than 80100 mg/m2 body area) CPA therapy in children with precocious puberty. These children fail to display signs of secondary adrenal insufficiency [for review see 14,43]. Androgen-like (Agonistic) Activities of CPA Based on rather non-specific tests for androgenicity it was claimed that CPA displays certain agonistic properties [44].

As mentioned above - and as will be shown later - CPA is also a highly potent progestin and, as such, inhibits gonadotrophin secretion (unlike pure anti androgens such as flutamide). CPA is therefore unique in combining the two basic prinCiples of androgen deprivation (dual 36 F. Neumann Table 2. Effects of cyproterone acetate on organs and functions Organ system/function Effect of cyproterone acetate Accessory sexual glands Spermatogenesis Libido and potency Puberty Male sexual differentiation Longitudinal bone growth Bone maturation, ossification Sebaceous gland function Atrophy, loss of secretory activity Inhibition Loss of libido (except in some rodents) Inhibition of onset of puberty Feminisation Retardation Retardation Inhibition mechanism of action): 1) reduction of androgen biosynthesis, and 2) inhibition of androgenic activity at the cellular level.

Neckar-Verlag, Villingen 1971 pp 114117 Raspe G (ed) Schering Symposium Ober Sexualdeviationen und ihre medikamentose Behandlung. Life Science Monographs 2. Pergamon Press, Vieweg, Oxford, Edinburgh, New York, Toronto, Sydney, Braunschweig 1972 38 Mothes C, Lehnert J, Samimi F and Ufer J: Klinische PrOfung von Cyproteronacetat (Androcur) bei Sexualdeviationen - Gesamtauswertung. Medizinische Mitteilungen (Schering AG) 1973 (2):26-39 39 Steinbeck H and Neumann F: Effect of cyproterone acetate on puberty.

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