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Clinical And Hormonal Effects Of Ketoconazole Therapy On Hirsutism
Hirsutizm'de Ketokonazol Tedavisinin Hormonal ve Klinik Etkileri
Turkiye Klinikleri J Gynecol Obst. 1992;2(3):205-8
Article Language: TR
Copyright Ⓒ 2020 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ÖZET
Ketokonazol oral olarak kullanılan antimikotik bir ajandır. Gonadal ve adrenal steroid sentezi üzerine çeşitli sitokrom p-450 enzimlerini bloke etmek suretiyle inhibitör etki yapar. Düşük dozlarda 17-alfa hidroksilaz ve 17-20 lyase üzerine olan selektif inhibisyonu ile androjen sentezini engellemekte ve hirşut kadınlarda kullanılmaktadır. Bu çalışmada; ketokonazol'ü 1 ay 1000 mg/gün yüksek dozda, 2 ay 400 mg/gün düşük dozda kullanarak, 37 hirsut kadında hormonal ve klinik etkilerini inceledik. Hastalarımızın 31'i tedaviyi tamamladı. 3 ay sonunda Free Testosteron'un 7.6±3.0 (ort. ±SD) pg/ml'den 4.3±1.9 pg/ml'ye (p<0.01), DHEA-S'nin 343.6±174.8 mg/dl'den 244.3±119.8 mg/dl'ye (p<0.05); FERRIMAN-GALLWAY indeksinin 20.54±4.55'den 16.84±4.98'e (p<0.01) düştüğü tespit edildi.
Ketokonazol oral olarak kullanılan antimikotik bir ajandır. Gonadal ve adrenal steroid sentezi üzerine çeşitli sitokrom p-450 enzimlerini bloke etmek suretiyle inhibitör etki yapar. Düşük dozlarda 17-alfa hidroksilaz ve 17-20 lyase üzerine olan selektif inhibisyonu ile androjen sentezini engellemekte ve hirşut kadınlarda kullanılmaktadır. Bu çalışmada; ketokonazol'ü 1 ay 1000 mg/gün yüksek dozda, 2 ay 400 mg/gün düşük dozda kullanarak, 37 hirsut kadında hormonal ve klinik etkilerini inceledik. Hastalarımızın 31'i tedaviyi tamamladı. 3 ay sonunda Free Testosteron'un 7.6±3.0 (ort. ±SD) pg/ml'den 4.3±1.9 pg/ml'ye (p<0.01), DHEA-S'nin 343.6±174.8 mg/dl'den 244.3±119.8 mg/dl'ye (p<0.05); FERRIMAN-GALLWAY indeksinin 20.54±4.55'den 16.84±4.98'e (p<0.01) düştüğü tespit edildi.
ANAHTAR KELİMELER: Hirsutizm, ketokonazol
ABSTRACT
Ketoconazole is an orally active antimycotic drug and a potent inhibitor of gonadal and adrenal steroid synthesis by blocking several cytochrome p-450 enzymes. By virtue of its selective action on androgen synthesis at low doses by inhibition of 17-alpha hydroxylase and 17-20 lyase, this could be of potential therapeutic utility in hirsutism. In this study; we evaluated the hormonal and clinical effects of a high dose regimen (1000 mg/day) for 1 month plus low dose regimen (400 mg/day) for 2 months in 37 women with a spectrum of disorders from idiopathic hirsutism to polycyystic ovary syndrome. Thirtyone of them complated 3-months treatment. Free testosteron decreased from 7.6±3.0 (mean±SD) to 4.3±1.9 pg/ml (p<0.01); DHEA-S from 343.6±174.8 to 244.3±119.8 mg/dl (p<0.05) and FERRIMAN GALLWAY scores from 20.54±4.55 to 16.84±4.98 (p<0.01).
Ketoconazole is an orally active antimycotic drug and a potent inhibitor of gonadal and adrenal steroid synthesis by blocking several cytochrome p-450 enzymes. By virtue of its selective action on androgen synthesis at low doses by inhibition of 17-alpha hydroxylase and 17-20 lyase, this could be of potential therapeutic utility in hirsutism. In this study; we evaluated the hormonal and clinical effects of a high dose regimen (1000 mg/day) for 1 month plus low dose regimen (400 mg/day) for 2 months in 37 women with a spectrum of disorders from idiopathic hirsutism to polycyystic ovary syndrome. Thirtyone of them complated 3-months treatment. Free testosteron decreased from 7.6±3.0 (mean±SD) to 4.3±1.9 pg/ml (p<0.01); DHEA-S from 343.6±174.8 to 244.3±119.8 mg/dl (p<0.05) and FERRIMAN GALLWAY scores from 20.54±4.55 to 16.84±4.98 (p<0.01).
Year 1992 - Volume 2 - Issue 3
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