DOCSLIB.ORG

The Medical Treatment of Endometriosis with Danazol

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Medical Treatment of Endometriosis with Danazol 2807400530 1 Hill THE MEDICAL TREATMENT OF ENDOMETRIOSIS WITH DANAZOL AND GESTRINONE A STUDY OF THEIR CLINICAL, ENDOCRINE AND IN VITRO EFFECTS A Thesis Presented for the Degree of Doctor of Medicine University of London By GILLIAN LINDA ROSE 1990 1 ProQuest Number: U043658 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a com plete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. uest ProQuest U043658 Published by ProQuest LLC(2018). Copyright of the Dissertation is held by the Author. All rights reserved. This work is protected against unauthorized copying under Title 17, United States C ode Microform Edition © ProQuest LLC. ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106- 1346 ABSTRACT This thesis describes an investigation of the clinical efficacy and mechanisms of action of danazol and the newer steroidal agent, gestrinone in the medical management of endometriosis. A prospective randomized double-blind study was performed on 51 patients treated with either danazol or gestrinone. The efficacy and tolerance of the two drugs were shown to be similar. The endocrine effects of danazol and gestrinone were found to be analogous. Treatment with both drugs resulted in early follicular phase levels of luteinizing hormone, follicle stimulating hormone and oestradiol, a fall in sex hormone binding globulin and an increase in percent free testosterone and the concentration of free testosterone. The latter is significantly related to the improvement in endometriosis seen during treatment. Although vaginal bleeding and oestradiol levels during therapy are also significantly related, neither of these parauneters correlate with effective elimination of endometriosis. The effect of gestrinone, danazol and the two major metabolites of danazol, ethisterone and 2-hydroxymethyl ethisterone were tested on endometrial tissue cells, Used as a model for endometriotic tissue, cultured in vitro. In view of the increase in free testosterone observed during treatment with the drugs, the effect of testosterone was 2 also examined. Danazol and testosterone at one and ten times the normal circulating concentrations caused a significant suppression of endometrial cell growth in vitro, but gestrinone, ethisterone and 2-hydroxymethyl ethisterone caused no effect. 3 This thesis is dedicated to my parents, Joyce and Cyril Rose. INDEX SECTION 1 PAGE 19 INTRODUCTION Chapter 1 PAGE 20 The aetiology, epidemiology and histogenesis of endometriosis Chapter 2 PAGE 47 The medical treatment of endometriosis SECTION 2 PAGE 66 THE CLINICAL EFFECTS OF DANAZOL AND GESTRINONE. A RANDOMIZED DOUBLE-BLIND STUDY Chapter 3 .............................................PAGE 67 Review of the clinical effects of danazol and gestrinone in the treatment of endometriosis Chapter 4.............................................PAGE 85 Study design and methods Chapter 5.............................................PAGE 94 Results Chapter 6.............................................PAGE 140 Discussion SECTION 3 PAGE 150 THE ENDOCRINE EFFECTS OF DANAZOL AND GESTRINONE Chapter 7............................................. PAGE 151 Review of the endocrine effects of danazol and gestrinone Chapter 8............................................. PAGE 165 Materials and methods Chapter 9............................................. PAGE 175 Results Chapter 10............................................ PAGE 208 Discussion 5 SECTION 4 PAGE 218 THE INVESTIGATION OF DANAZOL, DANAZOL METABOLITES, GESTRINONE, AND TESTOSTERONE ON THE GROWTH OF HUMAN ENDOMETRIAL CELLS IN VITRO Chapter 11........................................... PAGE 219 Previous experience in endometrial cell culture; a review Chapter 12........................................... PAGE 232 Materials and Methods Chapter 13........................................... PAGE 241 Results Chapter 14........................................... PAGE 258 Discussion SECTION 5.......................... ; PAGE 269 CONCLUSIONS AND SUMMARY Chapter 15 PAGE 270 Overall conclusions and the implications for future research REFERENCES................................... PAGE 279 APPENDIX..................................... PAGE 310 6 INDEX TO TABLES SECTION 1 TABLE 1.1 PAGE 22 Theories of the aetiology of endometriosis TABLE 1.2................................................ PAGE 28 Volume of peritoneal fluid in normal ovulatory women SECTION 2 TABLE 2.1................................................ PAGE 69 Symptomatic, clinical and laparoscopic assessment of danazol therapy. Results of previous series TABLE 2.2 PAGE 72 Fertility rates following danazol therapy. Results of previous studies TABLE 2.3................................................ PAGE 74 Recurrence rate after danazol treatment. Results of previous studies TABLE 2.4 PAGE 99 Symptoms before and during treatment with gestrinone and danazol: dysmenorrhoea TABLE 2.5.................................................PAGE 101 Symptoms before and during treatment with gestrinone and danazol:deep dyspareunia TABLE 2.6.................................................PAGE 103 Symptoms before and during treatment with gestrinone and danazol: superficial dyspareunia TABLE 2.7 PAGE 105 Symptoms before and during treatment with gestrinone and danazol: lower abdominal pain TABLE 2.8 PAGE 108 The incidence of expected side effects prior to treatment with gestrinone and danazol TABLE 2.9.................................................PAGE 110 The individual total AFS score pre- and post-treatment with gestrinone TABLE 2.10 PAGE 111 The individual endometriosis scores pre- and post-treatment with gestrinone TABLE 2.11 PAGE 112 The individual adhesion scores pre- and post-treatment with gestrinone 7- TABLE 2.12............................................. PAGE 113 The individual total AFS scores pre- and post-treatment with danazol TABLE 2.13............................................... PAGE 114 The individual endometriosis scores pre- and post-treatment with danazol TABLE 2.14.............................................. PAGE 115 The individual adhesion scores pre- and post-treatment with danazol TABLE 2.15.............................................. PAGE 116 The distribution of endometriosis scores into none, mild, moderate and severe, in patients before treatment with gestrinone and danazol TABLE 2.16.............................................. PAGE 118 The change in endometriosis, AFS and adhesion scores following six months' treatment with gestrinone and danazol TABLE 2.17.............................................. PAGE 117 The distribution of endometriosis scores into none, mild, moderate and severe, after treatment with gestrinone or danazol TABLE 2.18.............................................. PAGE 124 Subjective side effects before and during treatment with gestrinone and danazol: acne TABLE 2.19.............................................. PAGE 127 Subjective side effects before and during treatment with gestrinone and danazol: seborrhoea TABLE 2.20.............................................. PAGE 128 Subjective side effects before and during treatment with gestrinone and danazol: hirsutism TABLE 2.21............................................... PAGE 131 Subjective side effects before and during treatment with gestrinone and danazol: voice change TABLE 2.22.............................................. PAGE 133 Subjective side effects before and during treatment with gestrinone and danazol: headaches TABLE 2.23.............................................. PAGE 135 Subjective side effects before and during treatment with gestrinone and danazol: leg cramps TABLE 2. 24...............................................VPAGE 138 Subjective side effects before and during treatment with gestrinone and danazol: hot flushes 8’ SECTION 3 TABLE 3.1................................................. PAGE 176 Summary of the effects of gestrinone on mean ± SEM serum concentration of hormones (normal distribution) TABLE 3.2............................................... PAGE 177 Summary of the effects of danazol on mean + SEM serum concentration of hormones (normal distribution) TABLE 3.3 PAGE 178 Summary of the effects of gestrinone on geometric mean serum concentration of hormones (With upper and lower 95% confidence intervals) TABLE 3.4 PAGE 179 Summary of the effects of danazol on geometric mean serum concentrations of hormones (with upper and lower 95% confidence intervals) TABLE 3.5........ ! PAGE 180 Key to units and normal ranges for hormone values shown in tables 3.1-3.4 TABLE 3.6 PAGE 190 The effect of drugs on the mesurement of SHBG binding capacity in a pool of normal female serum SECTION 4 TABLE 4.1 PAGE 238 Plating efficiency of endometrial cells after 24 hours in culture TABLE 4.2.................................................PAGE 242 Relationship between cycle length and day of endometrial sampling TABLE 4.3 PAGE 244 Results from cells cultured from patient no. 6 the effect of gestrinone, danazol and testosterone at Xi and X10. TABLE 4.4 PAGE 245 The effect of treatment at XI dose on endometrial growth in vitro TABLE 4.5 PAGE 246 The effect of drug treatment at X10 dose on endometrial cell growth in vitro » TABLE 4.6.................................................PAGE 252 Results from cells cultured from patient no. 7. The effect
Load more

Recommended publications
  • Hormones and Breeding
    IN-DEPTH: REPRODUCTIVE ENDOCRINOLOGY Hormones and Breeding Carlos R.F. Pinto, MedVet, PhD, Diplomate ACT Author’s address: Theriogenology and Reproductive Medicine, Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210; e-mail: [email protected]. © 2013 AAEP. 1. Introduction affected by PGF treatment to induce estrus. In The administration of hormones to mares during other words, once luteolysis takes place, whether breeding management is an essential tool for equine induced by PGF treatment or occurring naturally, practitioners. Proper and timely administration of the events that follow (estrus behavior, ovulation specific hormones to broodmares may be targeted to and fertility) are essentially similar or minimally prevent reproductive disorders, to serve as an aid to affected (eg, decreased signs of behavioral estrus). treating reproductive disorders or hormonal imbal- Duration of diestrus and interovulatory intervals ances, and to optimize reproductive efficiency, for are shortened after PGF administration.1 The example, through induction of estrus or ovulation. equine corpus luteum (CL) is responsive to PGF These hormones, when administered exogenously, luteolytic effects any day after ovulation; however, act to control the duration and onset of the different only CL Ͼ5 days are responsive to one bolus injec- stages of the estrous cycle, specifically by affecting tion of PGF.2,3 Luteolysis or antiluteogenesis can duration of luteal function, hastening ovulation es- be reliably achieved in CL Ͻ5 days only if multiple pecially for timed artificial insemination and stimu- PGF treatments are administered. For that rea- lating myometrial activity in mares susceptible to or son, it became a widespread practice to administer showing delayed uterine clearance.
    [Show full text]
  • Detectx® Serum 17Β-Estradiol Enzyme Immunoassay Kit
    DetectX® Serum 17β-Estradiol Enzyme Immunoassay Kit 1 Plate Kit Catalog Number KB30-H1 5 Plate Kit Catalog Number KB30-H5 Species Independent Sample Types Validated: Multi-Species Serum and Plasma Please read this insert completely prior to using the product. For research use only. Not for use in diagnostic procedures. www.ArborAssays.com KB30-H WEB 210308 TABLE OF CONTENTS Background 3 Assay Principle 4 Related Products 4 Supplied Components 5 Storage Instructions 5 Other Materials Required 6 Precautions 6 Sample Types 7 Sample Preparation 7 Reagent Preparation 8 Assay Protocol 9 Calculation of Results 10 Typical Data 10-11 Validation Data Sensitivity, Linearity, etc. 11-13 Samples Values and Cross Reactivity 14 Warranty & Contact Information 15 Plate Layout Sheet 16 ® 2 EXPECT ASSAY ARTISTRY KB30-H WEB 210308 BACKGROUND 17β-Estradiol, C18H24O2, also known as E2 or oestradiol (1, 3, 5(10)-Estratrien-3, 17β-diol) is a key regulator of growth, differentiation, and function in a wide array of tissues, including the male and female reproductive tracts, mammary gland, brain, skeletal and cardiovascular systems. The predominant biological effects of E2 are mediated through two distinct intracellular receptors, ERα and ERβ, each encoded by unique genes possessing the functional domain characteristics of the steroid/thyroid hormone superfamily of nuclear receptors1. ERα is the predominant form expressed in the breast, uterus, cervix, and vagina. ERβ exhibits a more limited pattern and is primarily expressed in the ovary, prostate, testis, spleen, lung, hypothalamus, and thymus2. Estradiol also influences bone growth, brain development and maturation, and food intake3, and it is also critical in maintaining organ functions during severe trauma4,5.
    [Show full text]
  • A Guide to Feminizing Hormones – Estrogen
    1 | Feminizing Hormones ​ ​ A Guide to Feminizing Hormones Hormone therapy is an option that can help transgender and gender-diverse people feel more comfortable in their bodies. Like other medical treatments, there are benefits and risks. Knowing what to expect will help us work together to maximize the benefits and minimize the risks. What are hormones? Hormones are chemical messengers that tell the body’s cells how to function, ​ when to grow, when to divide, and when to die. They regulate many functions, including growth, sex drive, hunger, thirst, digestion, metabolism, fat burning & storage, blood sugar, cholesterol levels, and reproduction. What are sex hormones? Sex hormones regulate the development of sex characteristics, including the sex ​ organs such as genitals and ovaries/testicles. Sex hormones also affect the secondary sex characteristics that typically develop at puberty, like facial and body hair, bone growth, breast growth, and voice changes. There are three categories of sex hormones in the body: • Androgens: testosterone, dehydroepiandrosterone (DHEA), ​ dihydrotestosterone (DHT) • Estrogens: estradiol, estriol, estrone ​ • Progestin: progesterone ​ Generally, “males” tend to have higher androgen levels, and “females” tend to have higher levels of estrogens and progestogens. What is hormone therapy? Hormone therapy is taking medicine to change the levels of sex hormones in your body. Changing these levels will affect your hair growth, voice pitch, fat distribution, muscle mass, and other features associated with sex and gender. Feminizing hormone therapy can help make the body look and feel less “masculine” and more “feminine" — making your body more closely match your identity. What medicines are involved? There are different kinds of medicines used to change the levels of sex hormones in your body.
    [Show full text]
  • Hormonal Treatment Strategies Tailored to Non-Binary Transgender Individuals
    Journal of Clinical Medicine Review Hormonal Treatment Strategies Tailored to Non-Binary Transgender Individuals Carlotta Cocchetti 1, Jiska Ristori 1, Alessia Romani 1, Mario Maggi 2 and Alessandra Daphne Fisher 1,* 1 Andrology, Women’s Endocrinology and Gender Incongruence Unit, Florence University Hospital, 50139 Florence, Italy; [email protected] (C.C); jiska.ristori@unifi.it (J.R.); [email protected] (A.R.) 2 Department of Experimental, Clinical and Biomedical Sciences, Careggi University Hospital, 50139 Florence, Italy; [email protected]fi.it * Correspondence: fi[email protected] Received: 16 April 2020; Accepted: 18 May 2020; Published: 26 May 2020 Abstract: Introduction: To date no standardized hormonal treatment protocols for non-binary transgender individuals have been described in the literature and there is a lack of data regarding their efficacy and safety. Objectives: To suggest possible treatment strategies for non-binary transgender individuals with non-standardized requests and to emphasize the importance of a personalized clinical approach. Methods: A narrative review of pertinent literature on gender-affirming hormonal treatment in transgender persons was performed using PubMed. Results: New hormonal treatment regimens outside those reported in current guidelines should be considered for non-binary transgender individuals, in order to improve psychological well-being and quality of life. In the present review we suggested the use of hormonal and non-hormonal compounds, which—based on their mechanism of action—could be used in these cases depending on clients’ requests. Conclusion: Requests for an individualized hormonal treatment in non-binary transgender individuals represent a future challenge for professionals managing transgender health care. For each case, clinicians should balance the benefits and risks of a personalized non-standardized treatment, actively involving the person in decisions regarding hormonal treatment.
    [Show full text]
  • How to Select Pharmacologic Treatments to Manage Recidivism Risk in Sex Off Enders
    How to select pharmacologic treatments to manage recidivism risk in sex off enders Consider patient factors when choosing off -label hormonal and nonhormonal agents ® Dowden Healthex offenders Media traditionally are managed by the criminal justice system, but psychiatrists are fre- Squently called on to assess and treat these indi- CopyrightFor personalviduals. use Part only of the reason is the overlap of paraphilias (disorders of sexual preference) and sexual offending. Many sexual offenders do not meet DSM criteria for paraphilias,1 however, and individuals with paraphil- ias do not necessarily commit offenses or come into contact with the legal system. As clinicians, we may need to assess and treat a wide range of sexual issues, from persons with paraphilias who are self-referred and have no legal involvement, to recurrent sexual offenders who are at a high risk of repeat offending. Successfully managing sex offenders includes psychological and pharmacologic interven- 2009 © CORBIS / TIM PANNELL 2009 © CORBIS / tions and possibly incarceration and post-incarceration Bradley D. Booth, MD surveillance. This article focuses on pharmacologic in- Assistant professor terventions for male sexual offenders. Department of psychiatry Director of education Integrated Forensics Program University of Ottawa Reducing sexual drive Ottawa, ON, Canada Sex offending likely is the result of a complex inter- play of environment and psychological and biologic factors. The biology of sexual function provides nu- merous targets for pharmacologic intervention, in- cluding:2 • endocrine factors, such as testosterone • neurotransmitters, such as serotonin. The use of pharmacologic treatments for sex of- fenders is off-label, and evidence is limited. In general, Current Psychiatry 60 October 2009 pharmacologic treatments are geared toward reducing For mass reproduction, content licensing and permissions contact Dowden Health Media.
    [Show full text]
  • Antiluteogenic Effects of Serial Prostaglandin F2α Administration in Mares
    ANTILUTEOGENIC EFFECTS OF SERIAL PROSTAGLANDIN F2α ADMINISTRATION IN MARES Thesis Presented in partial fulfillment of the requirements for the Master of Science in the Graduate School of The Ohio State University Elizabeth Ann Coffman Graduate ProGram in Comparative and Veterinary Medicine The Ohio State University 2013 Thesis committee: Carlos R.F. Pinto PhD, MV, DACT; Dissertation Advisor Marco A. Coutinho da Silva PhD, MV, DACT; Academic Advisor Christopher Premanandan PhD, DVM, DACVP Copyright by Elizabeth Ann Coffman 2013 Abstract For breedinG manaGement and estrus synchronization, prostaGlandin F2α (PGF) is one of the most commonly utilized hormones to pharmacologically manipulate the equine estrous cycle. There is a general supposition a sinGle dose of PGF does not consistently induce luteolysis in the equine corpus luteum (CL) until at least five to six days after ovulation. This leads to the erroneous assumption that the early CL (before day five after ovulation) is refractory to the luteolytic effects of PGF. An experiment was desiGned to test the hypotheses that serial administration of PGF in early diestrus would induce a return to estrus similar to mares treated with a sinGle injection in mid diestrus, and fertility of the induced estrus for the two treatment groups would not differ. The specific objectives of the study were to evaluate the effects of early diestrus treatment by: 1) assessing the luteal function as reflected by hormone profile for concentration of plasma progesterone; 2) determininG the duration of interovulatory and treatment to ovulation intervals; 3) comparing of the number of pregnant mares at 14 days post- ovulation. The study consisted of a balanced crossover desiGn in which reproductively normal Quarter horse mares (n=10) were exposed to two treatments ii on consecutive reproductive cycles.
    [Show full text]
  • Pp375-430-Annex 1.Qxd
    ANNEX 1 CHEMICAL AND PHYSICAL DATA ON COMPOUNDS USED IN COMBINED ESTROGEN–PROGESTOGEN CONTRACEPTIVES AND HORMONAL MENOPAUSAL THERAPY Annex 1 describes the chemical and physical data, technical products, trends in produc- tion by region and uses of estrogens and progestogens in combined estrogen–progestogen contraceptives and hormonal menopausal therapy. Estrogens and progestogens are listed separately in alphabetical order. Trade names for these compounds alone and in combination are given in Annexes 2–4. Sales are listed according to the regions designated by WHO. These are: Africa: Algeria, Angola, Benin, Botswana, Burkina Faso, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Comoros, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mauritius, Mozambique, Namibia, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, South Africa, Swaziland, Togo, Uganda, United Republic of Tanzania, Zambia and Zimbabwe America (North): Canada, Central America (Antigua and Barbuda, Bahamas, Barbados, Belize, Costa Rica, Cuba, Dominica, El Salvador, Grenada, Guatemala, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Panama, Puerto Rico, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Suriname, Trinidad and Tobago), United States of America America (South): Argentina, Bolivia, Brazil, Chile, Colombia, Dominican Republic, Ecuador, Guyana, Paraguay,
    [Show full text]
  • Exposure to Female Hormone Drugs During Pregnancy
    British Journal of Cancer (1999) 80(7), 1092–1097 © 1999 Cancer Research Campaign Article no. bjoc.1998.0469 Exposure to female hormone drugs during pregnancy: effect on malformations and cancer E Hemminki, M Gissler and H Toukomaa National Research and Development Centre for Welfare and Health, Health Services Research Unit, PO Box 220, 00531 Helsinki, Finland Summary This study aimed to investigate whether the use of female sex hormone drugs during pregnancy is a risk factor for subsequent breast and other oestrogen-dependent cancers among mothers and their children and for genital malformations in the children. A retrospective cohort of 2052 hormone-drug exposed mothers, 2038 control mothers and their 4130 infants was collected from maternity centres in Helsinki from 1954 to 1963. Cancer cases were searched for in national registers through record linkage. Exposures were examined by the type of the drug (oestrogen, progestin only) and by timing (early in pregnancy, only late in pregnancy). There were no statistically significant differences between the groups with regard to mothers’ cancer, either in total or in specified hormone-dependent cancers. The total number of malformations recorded, as well as malformations of the genitals in male infants, were higher among exposed children. The number of cancers among the offspring was small and none of the differences between groups were statistically significant. The study supports the hypothesis that oestrogen or progestin drug therapy during pregnancy causes malformations among children who were exposed in utero but does not support the hypothesis that it causes cancer later in life in the mother; the power to study cancers in offspring, however, was very low.
    [Show full text]
  • Us Anti-Doping Agency
    2019U.S. ANTI-DOPING AGENCY WALLET CARDEXAMPLES OF PROHIBITED AND PERMITTED SUBSTANCES AND METHODS Effective Jan. 1 – Dec. 31, 2019 CATEGORIES OF SUBSTANCES PROHIBITED AT ALL TIMES (IN AND OUT-OF-COMPETITION) • Non-Approved Substances: investigational drugs and pharmaceuticals with no approval by a governmental regulatory health authority for human therapeutic use. • Anabolic Agents: androstenediol, androstenedione, bolasterone, boldenone, clenbuterol, danazol, desoxymethyltestosterone (madol), dehydrochlormethyltestosterone (DHCMT), Prasterone (dehydroepiandrosterone, DHEA , Intrarosa) and its prohormones, drostanolone, epitestosterone, methasterone, methyl-1-testosterone, methyltestosterone (Covaryx, EEMT, Est Estrogens-methyltest DS, Methitest), nandrolone, oxandrolone, prostanozol, Selective Androgen Receptor Modulators (enobosarm, (ostarine, MK-2866), andarine, LGD-4033, RAD-140). stanozolol, testosterone and its metabolites or isomers (Androgel), THG, tibolone, trenbolone, zeranol, zilpaterol, and similar substances. • Beta-2 Agonists: All selective and non-selective beta-2 agonists, including all optical isomers, are prohibited. Most inhaled beta-2 agonists are prohibited, including arformoterol (Brovana), fenoterol, higenamine (norcoclaurine, Tinospora crispa), indacaterol (Arcapta), levalbuterol (Xopenex), metaproternol (Alupent), orciprenaline, olodaterol (Striverdi), pirbuterol (Maxair), terbutaline (Brethaire), vilanterol (Breo). The only exceptions are albuterol, formoterol, and salmeterol by a metered-dose inhaler when used
    [Show full text]
  • Anabolic Steroids/Androgens Pa Summary
    ANABOLIC STEROIDS/ANDROGENS PA SUMMARY PREFERRED Anadrol-50, Danazol, Fluoxymesterone, Methitest, Oxandrolone, Testosterone Cypionate Injection, Testosterone Enanthate Injection NON-PREFERRED Android, Testred LENGTH OF AUTHORIZATION: Varies NOTE: All preferred and non-preferred agents require prior authorization. See PA criteria labeled “Topical Testosterone” for Androderm, Androgel, Striant, and Testim. The criteria details below are for the outpatient pharmacy program. If an injectable medication is being administered in a physician’s office then the criteria information below does not apply. Instead, the physician’s office must bill this drug through the DCH physician’s injectable program and not the outpatient pharmacy program. Information regarding the physician’s injectable program can be located at www.mmis.georgia.gov. PA CRITERIA: For Anadrol-50 Approvable for the following diagnoses: anemia caused by deficient red blood cell production, acquired or congenital aplastic anemia, myelofibrosis, hypoplastic anemia due to administration of myelotoxic drugs Also approvable for HIV or AIDS wasting when significant weight loss is documented in members currently receiving nutritional support For Danazol Approvable for the following diagnoses: endometriosis, fibrocystic breast disease, hereditary angioedema For Fluoxymesterone, Methyltestosterone (Android, Methitest, Testred), Testosterone Cypionate or Enanthate Injection Approvable in male members 12 years of age or older for the following diagnoses: primary hypogonadism, secondary
    [Show full text]
  • Progestogens and Venous Thromboembolism Among Postmenopausal Women Using Hormone Therapy. Marianne Canonico, Geneviève Plu-Bureau, Pierre-Yves Scarabin
    Progestogens and venous thromboembolism among postmenopausal women using hormone therapy. Marianne Canonico, Geneviève Plu-Bureau, Pierre-Yves Scarabin To cite this version: Marianne Canonico, Geneviève Plu-Bureau, Pierre-Yves Scarabin. Progestogens and venous throm- boembolism among postmenopausal women using hormone therapy.. Maturitas, Elsevier, 2011, 70 (4), pp.354-60. 10.1016/j.maturitas.2011.10.002. inserm-01148705 HAL Id: inserm-01148705 https://www.hal.inserm.fr/inserm-01148705 Submitted on 5 May 2015 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Progestogens and VTE Finale version Progestogens and venous thromboembolism among postmenopausal women using hormone therapy Marianne Canonico1,2, Geneviève Plu-Bureau1,3 and Pierre-Yves Scarabin1,2 1 Centre for Research in Epidemiology and Population Health, U1018, Hormones and Cardiovascular Disease 2 University Paris-Sud, UMR-S 1018, Villejuif, France 3 University Paris Descartes and Hôtel-Dieu Hospital, Paris, France Adresse: 16 av. Paul Vaillant Couturier 94807 Villejuif Cedex Tel: +33 1 45 59 51 66 Fax: +33 1 45 59 51 70 Corresponding author: Marianne Canonico ([email protected]) 1/21 Progestogens and VTE Finale version Abstract Hormone therapy (HT) is the most effective treatment for correcting menopausal symptoms after menopause.
    [Show full text]
  • University of Groningen Multi-Residue Analysis of Growth Promotors In
    University of Groningen Multi-residue analysis of growth promotors in food-producing animals Koole, Anneke IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below. Document Version Publisher's PDF, also known as Version of record Publication date: 1998 Link to publication in University of Groningen/UMCG research database Citation for published version (APA): Koole, A. (1998). Multi-residue analysis of growth promotors in food-producing animals. s.n. Copyright Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons). Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Download date: 25-09-2021 APPENDIX 1 OVERVIEW OF RELEVANT SUBSTANCES This appendix consists of two parts. First, substances that are relevant for the research presented in this thesis are given. For each substance CAS number (CAS), molecular weight (MW), bruto formula (formula) and if available UV maxima and alternative names are given. In addition, pKa values for the ß-agonists are listed, if they were available.
    [Show full text]