Selective Estrogen Receptor Modulators Œ an Update
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Prospective Study on Gynaecological Effects of Two Antioestrogens Tamoxifen and Toremifene in Postmenopausal Women
British Journal of Cancer (2001) 84(7), 897–902 © 2001 Cancer Research Campaign doi: 10.1054/ bjoc.2001.1703, available online at http://www.idealibrary.com on http://www.bjcancer.com Prospective study on gynaecological effects of two antioestrogens tamoxifen and toremifene in postmenopausal women MB Marttunen1, B Cacciatore1, P Hietanen2, S Pyrhönen2, A Tiitinen1, T Wahlström3 and O Ylikorkala1 1Departments of Obstetrics and Gynecology, Helsinki University Central Hospital, P.O. Box 140, FIN-00029 HYKS, Finland; 2Department of Oncology, Helsinki University Central Hospital, P.O. Box 180, FIN-00029 HYKS, Finland; 3Department of Pathology, Helsinki University Central Hospital, P.O. Box 140, FIN-00029 HYKS, Finland Summary To assess and compare the gynaecological consequences of the use of 2 antioestrogens we examined 167 postmenopausal breast cancer patients before and during the use of either tamoxifen (20 mg/day, n = 84) or toremifene (40 mg/day, n = 83) as an adjuvant treatment of stage II–III breast cancer. Detailed interview concerning menopausal symptoms, pelvic examination including transvaginal sonography (TVS) and collection of endometrial sample were performed at baseline and at 6, 12, 24 and 36 months of treatment. In a subgroup of 30 women (15 using tamoxifen and 15 toremifene) pulsatility index (PI) in an uterine artery was measured before and at 6 and 12 months of treatment. The mean (±SD) follow-up time was 2.3 ± 0.8 years. 35% of the patients complained of vasomotor symptoms before the start of the trial. This rate increased to 60.0% during the first year of the trial, being similar among patients using tamoxifen (57.1%) and toremifene (62.7%). -
Phase II Study of Hormone Therapy with Tamoxifen in Patients with Well Differentiated Neuroendocrine Tumors and Hormone Receptor Positive Expression (HORMONET)
Phase II study of hormone therapy with tamoxifen in patients with well differentiated neuroendocrine tumors and hormone receptor positive expression (HORMONET) Time of researchers and respective Departments: Rachel Riechelmann (Main Investigador)1, Milton Barros 1, Marcos Camandaroba1,2, Virgilio Souza1,2, Celso Abdon Mello1, Paula Nicole3, Eduardo Nóbrega4, Ludmilla Chinen5, Marina De Brot6, Héber Salvador7. Departaments: 1- Clinical Oncology; 2- postgraduate student; 3- Radiology; 4- Nuclear Medicine; 5-International Research Center (CIPE); 6-Pathologic anatomy; 7- Abdomen Surgery AC Camargo Cancer Center - Brazil Registration Number on Institutional Research Ethics Committee: 2626/18 March,06,2019 Introduction Neuroendocrine tumors (NET) are rare neoplasms, but with increasing incidence and prevalence in the last decades. Although they may manifest in the most diverse tissues, the vast majority of cases will affect organs of the digestive tract and lung. At diagnosis, more than half of the cases present metastatic disease, and among patients with localized disease, up to one-third will have recurrence of the disease. Unfortunately, the minority of patients with metastatic disease are eligible for curative intent.1 Although there are many types of NET, they are often studied together as a group because their cells share common histological findings, have special secretory granules, and the ability to secrete bioactive amines and polypeptide hormones. Approximately 25 percent of the tumors present functional hormonal syndromes (situation of great morbidity for these patients), being the carcinoid syndrome, the most common one. From the molecular point of view, these neoplasias are largely dependent on the activation of the mTOR pathway and neoangiogenesis.2 Another striking feature of neuroendocrine cells is the expression of cell surface hormone receptors whose activation or blockade may exert an important regulatory function. -
Nitrate Prodrugs Able to Release Nitric Oxide in a Controlled and Selective
Europäisches Patentamt *EP001336602A1* (19) European Patent Office Office européen des brevets (11) EP 1 336 602 A1 (12) EUROPEAN PATENT APPLICATION (43) Date of publication: (51) Int Cl.7: C07C 205/00, A61K 31/00 20.08.2003 Bulletin 2003/34 (21) Application number: 02425075.5 (22) Date of filing: 13.02.2002 (84) Designated Contracting States: (71) Applicant: Scaramuzzino, Giovanni AT BE CH CY DE DK ES FI FR GB GR IE IT LI LU 20052 Monza (Milano) (IT) MC NL PT SE TR Designated Extension States: (72) Inventor: Scaramuzzino, Giovanni AL LT LV MK RO SI 20052 Monza (Milano) (IT) (54) Nitrate prodrugs able to release nitric oxide in a controlled and selective way and their use for prevention and treatment of inflammatory, ischemic and proliferative diseases (57) New pharmaceutical compounds of general effects and for this reason they are useful for the prep- formula (I): F-(X)q where q is an integer from 1 to 5, pref- aration of medicines for prevention and treatment of in- erably 1; -F is chosen among drugs described in the text, flammatory, ischemic, degenerative and proliferative -X is chosen among 4 groups -M, -T, -V and -Y as de- diseases of musculoskeletal, tegumental, respiratory, scribed in the text. gastrointestinal, genito-urinary and central nervous sys- The compounds of general formula (I) are nitrate tems. prodrugs which can release nitric oxide in vivo in a con- trolled and selective way and without hypotensive side EP 1 336 602 A1 Printed by Jouve, 75001 PARIS (FR) EP 1 336 602 A1 Description [0001] The present invention relates to new nitrate prodrugs which can release nitric oxide in vivo in a controlled and selective way and without the side effects typical of nitrate vasodilators drugs. -
And Active-Controlled Phase 3 Study of Postmenopausal Women with Osteoporosis
Christiansen et al. BMC Musculoskeletal Disorders 2010, 11:130 http://www.biomedcentral.com/1471-2474/11/130 RESEARCH ARTICLE Open Access SafetyResearch article of bazedoxifene in a randomized, double-blind, placebo- and active-controlled phase 3 study of postmenopausal women with osteoporosis Claus Christiansen*1, Charles H Chesnut III2, Jonathan D Adachi3, Jacques P Brown4, César E Fernandes5, Annie WC Kung6, Santiago Palacios7, Amy B Levine8, Arkadi A Chines8 and Ginger D Constantine8 Abstract Background: We report the safety findings from a 3-year phase 3 study (NCT00205777) of bazedoxifene, a novel selective estrogen receptor modulator under development for the prevention and treatment of postmenopausal osteoporosis. Methods: Healthy postmenopausal osteoporotic women (N = 7,492; mean age, 66.4 years) were randomized to daily doses of bazedoxifene 20 or 40 mg, raloxifene 60 mg, or placebo for 3 years. Safety and tolerability were assessed by adverse event (AE) reporting and routine physical, gynecologic, and breast examination. Results: Overall, the incidence of AEs, serious AEs, and discontinuations due to AEs in the bazedoxifene groups was not different from that seen in the placebo group. The incidence of hot flushes and leg cramps was higher with bazedoxifene or raloxifene compared with placebo. The rates of cardiac disorders and cerebrovascular events were low and evenly distributed among groups. Venous thromboembolic events, primarily deep vein thromboses, were more frequently reported in the active treatment groups compared with the placebo group; rates were similar with bazedoxifene and raloxifene. Bazedoxifene showed a neutral effect on the breast and an excellent endometrial safety profile. The incidence of fibrocystic breast disease was lower with bazedoxifene 20 and 40 mg versus raloxifene or placebo. -
Clomifene Citrate(BANM, Rinnm) ⊗
2086 Sex Hormones and their Modulators Profasi; UK: Choragon; Ovitrelle; Pregnyl; USA: Chorex†; Choron; Gonic; who received the drug for a shorter period.6 No association be- 8. Werler MM, et al. Ovulation induction and risk of neural tube Novarel; Ovidrel; Pregnyl; Profasi; Venez.: Ovidrel; Pregnyl; Profasi†. tween gonadotrophin therapy and ovarian cancer was noted in defects. Lancet 1994; 344: 445–6. Multi-ingredient: Ger.: NeyNormin N (Revitorgan-Dilutionen N Nr this study. The conclusions of this study were only tentative, 9. Greenland S, Ackerman DL. Clomiphene citrate and neural tube 65)†; Mex.: Gonakor. defects: a pooled analysis of controlled epidemiologic studies since the numbers who developed ovarian cancer were small; it and recommendations for future studies. Fertil Steril 1995; 64: has been pointed out that a successfully achieved pregnancy may 936–41. reduce the risk of some other cancers, and that the risks and ben- 10. Whiteman D, et al. Reproductive factors, subfertility, and risk efits of the procedure are not easy to balance.7 A review8 of epi- of neural tube defects: a case-control study based on the Oxford Clomifene Citrate (BANM, rINNM) ⊗ Record Linkage Study Register. Am J Epidemiol 2000; 152: demiological and cohort studies concluded that clomifene was 823–8. Chloramiphene Citrate; Citrato de clomifeno; Clomifène, citrate not associated with any increase in the risk of ovarian cancer 11. Sørensen HT, et al. Use of clomifene during early pregnancy de; Clomifeni citras; Clomiphene Citrate (USAN); Klomifeenisi- when used for less than 12 cycles, but noted conflicting results, and risk of hypospadias: population based case-control study. -
Genitourinary Syndrome of Menopause in Breast Cancer Survivors: Are We Facing New and Safe Hopes?
Review Genitourinary Syndrome of Menopause in Breast Cancer Survivors: Are We Facing New and Safe Hopes? Nicoletta Biglia,1 Valentina E. Bounous,1 Luca G. Sgro,1 Marta D’Alonzo,1 Silvia Pecchio,1 Rossella E. Nappi2 Abstract Breast cancer survivors (BCSs) often suffer from menopausal symptoms induced by systemic treatments, with a consequent negative effect on quality of life. Since the introduction of aromatase inhibitors as the standard therapy for hormone-dependent tumors, genitourinary syndrome of menopause (GSM) has become a main problem for BCSs. This new terminology refers to the wide range of vaginal and urinary symptoms related to menopause, which can be relieved by estrogen therapy. Unfortunately, systemic hormone therapy is contraindicated for BCSs and also vaginal estrogens at standard dosage might influence the risk of recurrence because they cause a significant increase of circulating estrogens. Nonhormonal vaginal moisturizers or lubricants are the first choice for BCSs but only have limited and short-term efficacy. New strategies of management of GSM are now available, including: (1) low-dose or ultra low-dose vaginal estrogens; (2) oral selective estrogen receptor modulators (ospemifene); (3) androgen therapy; (4) physical treatment with vaginal laser; and (5) psychosocial interventions. In this review we discuss and analyze these different options. Clinical Breast Cancer, Vol. -, No. -, --- ª 2015 Elsevier Inc. All rights reserved. Keywords: BCS, GSM, Iatrogenic menopause, Treatment, Vulvovaginal atrophy (VVA) Introduction vasomotor symptoms are the most common side effects, affecting Breast cancer affects 1 of 8 women who live up to the age of 85 approximately 65% of BCSs.3 Even vulvovaginal atrophy (VVA) is years in Western countries. -
Clomid (Clomiphene Citrate USP)
PRODUCT MONOGRAPH PrCLOMID® (clomiphene citrate USP) 50 mg Tablets Ovulatory Agent sanofi-aventis Canada Inc. Date of Revision: 2905 Place Louis-R.-Renaud August 9, 2013 Laval, Quebec H7V 0A3 Submission Control No.: 165671 s-a Version 5.0 dated August 9, 2013 Page 1 of 23 PRODUCT MONOGRAPH PrCLOMID® (clomiphene citrate USP) 50 mg Tablets Ovulatory agent. ACTION AND CLINICAL PHARMACOLOGY CLOMID (clomiphene citrate) is an orally-administered, non-steroidal agent which may induce ovulation in anovulatory women in appropriately selected cases.1-16 The ovulatory response to cyclic CLOMID therapy appears to be mediated through increased output of pituitary gonadotropins, which in turn stimulate the maturation and endocrine activity of the ovarian follicle and the subsequent development and function of the corpus luteum. The role of the pituitary is indicated by increased plasma levels of gonadotropins and by the response of the ovary, as manifested by increased plasma level of estradiol. Antagonism of competitive inhibition of endogenous estrogen may play a role in the action of CLOMID on the hypothalamus. CLOMID is a drug of considerable pharmacologic potency. Its administration should be preceded by careful evaluation and selection of the patient, and must be accompanied by close attention to the timing of the dose. With conservative selection and management of the patient, CLOMID has been demonstrated to be a useful therapy for the anovulatory patient. Based on studies with 14C-labeled clomiphene, the drug is readily absorbed orally in humans, and is excreted principally in the feces. Cumulative excretion of the 14C-label averaged 51% of the oral dose after 5 days in 6 subjects, with mean urinary excretion of 8% and mean fecal excretion of 42%; less than 1% per day was excreted in fecal and urine samples collected from 31 to 53 days after 14C-labelled clomiphene administration. -
Management of Women with Clomifene Citrate Resistant Polycystic Ovary Syndrome – an Evidence Based Approach
1 Management of Women with Clomifene Citrate Resistant Polycystic Ovary Syndrome – An Evidence Based Approach Hatem Abu Hashim Department of Obstetrics & Gynecology, Faculty of Medicine, Mansoura University, Mansoura, Egypt 1. Introduction World Health Organisation (WHO) type II anovulation is defined as normogonadotrophic normoestrogenic anovulation and occurs in approximately 85% of anovulatory patients. Polycystic ovary syndrome (PCOS) is the most common form of WHO type II anovulatory infertility and is associated with hyperandrogenemia (1,2). Moreover, PCOS is the most common endocrine abnormality in reproductive age women. The prevalence of PCOS is traditionally estimated at 4% to 8% from studies performed in Greece, Spain and the USA (3-6). The prevalence of PCOS has increased with the use of different diagnostic criteria and has recently been shown to be 11.9 ± 2.4% -17.8 ± 2.8 in the first community-based prevalence study based on the current Rotterdam diagnostic criteria compared with 10.2 ± 2.2% -12.0 ± 2.4% and 8.7 ± 2.0% using National Institutes of Health criteria and Androgen Excess Society recommendations respectively (7). Importantly, 70% of women in this recent study were undiagnosed (7). Clomiphene citrate (CC) is still holding its place as the first-line therapy for ovulation induction in these patients (2,8,9). CC contains an unequal mixture of two isomers as their citrate salts, enclomiphene and zuclomiphene. Zuclomiphene is much the more potent of the two for induction of ovulation, accounts for 38% of the total drug content of one tablet and has a much longer half-life than enclomiphene, being detectable in plasma 1 month following its administration (10). -
Eraas for Menopause Treatment: Welcome the ‘Designer Estrogens’
REVIEW CME LEARNING OBJECTIVE: Readers will tailor hormone therapy to the needs of the patient CREDIT HEATHER D. HIRSCH, MD, MS, NCMP ELIM SHIH, MD, NCMP HOLLY L. THACKER, MD, NCMP Assistant Professor, Clinical Internal Medicine, Division Department of Obstetrics and Gynecology, Director of Center for Specialized Women’s Health, of General Internal Medicine, The Ohio State University, Women’s Health Institute, Cleveland Clinic Department of Obstetrics and Gynecology, Women’s Columbus, and Center for Women’s Health, Health Institute, Cleveland Clinic; Professor, Cleveland The Ohio State University Wexner Medical Center, Clinic Lerner College of Medicine of Case Western Upper Arlington, OH Reserve University, Cleveland, OH ERAAs for menopause treatment: Welcome the ‘designer estrogens’ ABSTRACT strogen receptor agonist-antagonists E(ERAAs), previously called selective es- Estrogen receptor agonist-antagonists (ERAAs) selec- trogen receptor modulators (SERMs), have tively inhibit or stimulate estrogen-like action in targeted extended the options for treating the vari- tissues. This review summarizes how ERAAs can be used ous conditions that menopausal women suffer in combination with an estrogen or alone to treat meno- from. These drugs act differently on estrogen pausal symptoms (vasomotor symptoms, genitourinary receptors in different tissues, stimulating re- syndrome of menopause), breast cancer or the risk of ceptors in some tissues but inhibiting them breast cancer, osteopenia, osteoporosis, and other female in others. This allows selective inhibition or midlife concerns. stimulation of estrogen-like action in various target tissues.1 KEY POINTS This article highlights the use of ERAAs Tamoxifen is approved to prevent and treat breast cancer. to treat menopausal vasomotor symptoms It may also have beneficial effects on bone and on car- (eg, hot flashes, night sweats), genitourinary diovascular risk factors, but these are not approved uses. -
The Role of Sevista in the Management of Dysfunctional Uterine Bleeding Section Obstetrics & Gynaecology
Original Article DOI: 10.7860/JCDR/2012/4794.2687 The Role of Sevista in the Management of Dysfunctional Uterine Bleeding Section Obstetrics & Gynaecology DHANANJAY BS, SUNIL KUMAR NANDA ABSTRACT bleeding, a diagnosis of DUB was made and the treatment with Objective: The complaints of excessive menstrual bleeding ormiloxifene was started. The number of cases were 35 cases. (menorrhagia) have a substantial impact on the gynaecological The treatment with ormeloxifene was evaluated by measuring services and in most of the cases, no organic pathology is iden- the Hb g/dl and the endometrial thickness before and after 3 tified. Nonsteroidal anti-inflammatory drugs and tranexamic acid months of treatment with sevista. Ormeloxifene was given in the offer a simple therapy which has to be taken during menses, with dosage of a 60 mg tablet twice a week for 3 months, followed by reductions of 25-35% and 50% respectively in the Menstrual once a week for another 3 months. Blood Loss (MBL). Danazol and the gonadatrophin-releasing Observation & Results: There was a statistically significant in- hormone analogues are highly effective, but their side-effects crease in the Hb g/dl (p < 0.001) and a statistically significant make them suitable only for a short-term use. In the present decrease in the endometrial thickness (p< 0.001) after the treat- study, the role of ormeloxifene was studied in patients of DUB. ment with ormeloxifene. Materials & Methods: The subjects were diagnosed cases of Conclusion: Ormeloxifene can be used asa effective drug in the DUB. After ruling out the possible causes of the abnormal uterine treatment of Dysfunctional uterine bleeding. -
Universidade Estadual De Campinas Faculdade De Engenharia De Alimentos Naice Eleidiane Santana Monteiro Evaluation of Probiotics
UNIVERSIDADE ESTADUAL DE CAMPINAS FACULDADE DE ENGENHARIA DE ALIMENTOS NAICE ELEIDIANE SANTANA MONTEIRO EVALUATION OF PROBIOTICS ON INFLUENCE IN THE ABSORPTION AND PRODUCTION OF SOY ISOFLAVONES METABOLITES IN MENOPAUSAL WOMEN WITH CLIMATERIC SYMPTOMATOLOGY AVALIAÇÃO DA INFLUÊNCIA DE PROBIÓTICOS NA ABSORÇÃO E PRODUÇÃO DE METABÓLITOS DE ISOFLAVONAS DA SOJA EM MULHERES MENOPAUSADAS COM SINTOMATOLOGIA CLIMATÉRICA CAMPINAS 2018 NAICE ELEIDIANE SANTANA MONTEIRO EVALUATION OF PROBIOTICS ON INFLUENCE IN THE ABSORPTION AND PRODUCTION OF SOY ISOFLAVONES METABOLITES IN MENOPAUSAL WOMEN WITH CLIMATERIC SYMPTOMATOLOGY AVALIAÇÃO DA INFLUÊNCIA DE PROBIÓTICOS NA ABSORÇÃO E PRODUÇÃO DE METABÓLITOS DE ISOFLAVONAS DA SOJA EM MULHERES MENOPAUSADAS COM SINTOMATOLOGIA CLIMATÉRICA Thesis presented to School of Food Engineering of University of Campinas as part of the requirements for PhD in Food and Nutrition in Experimental Nutrition and Applied to Food Technology area. Tese apresentada à Faculdade de Engenharia de Alimentos da Universidade Estadual de Campinas como parte dos requisitos exigidos para a obtenção do título de Doutora em Alimentos e Nutrição na Área de Nutrição Experimental e aplicada à Tecnologia de Alimentos. ORIENTADOR: GABRIELA ALVES MACEDO COORIENTADOR: ADRIANA ORCESI PEDRO CAMPANA ESTE EXEMPLAR CORRESPONDE A VERSÃO FINAL DA TESE DEFENDIDA PELA ALUNA NAICE ELEIDIANE SANTANA MONTEIRO, E ORIENTADA PELA PROFª. DRª. GABRIELA ALVES MACEDO. CAMPINAS 2018 BANCA EXAMINADORA DA DEFESA DE DOUTORADO NAICE ELEIDIANE SANTANA MONTEIRO MEMBROS: 1. PROF. DR. GABRIELA ALVES MACEDO - PRESIDENTE - (UNIVERSIDADE ESTADUAL DE CAMPINAS) 2. PROF. DR. ANA LUCIA TASCA GOIS RUIZ (UNIVERSIDADE ESTADUAL DE CAMPINAS) 3. PROF. DR. JOELISE DE ALENCAR FIGUEIRA ANGELOTTI (UNIVERSIDADE FEDERAL DE ALFENAS) 4. PROF. DR. LOUISE EMY KUROZAWA (UNIVERSIDADE ESTADUAL DE CAMPINAS) 5. -
Interaction Between the Effects of the Selective Estrogen Modulator Femarelle and a Vitamin D Analog in Human Umbilical Artery V
Journal of Steroid Biochemistry and Molecular Biology xxx (xxxx) xxx–xxx Contents lists available at ScienceDirect Journal of Steroid Biochemistry and Molecular Biology journal homepage: www.elsevier.com/locate/jsbmb Interaction between the effects of the selective estrogen modulator femarelle and a vitamin D analog in human umbilical artery vascular smooth muscle cells ⁎ Dalia Somjen , Esther Knoll, Orli Sharon, Ariel Many, Naftali Stern Institute of Endocrinology, Metabolism and Hypertension, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, 64239, Israel ARTICLE INFO ABSTRACT Keywords: To further investigate the interaction between vitamin D system and estrogen-mimetic compounds in the human Vascular smooth muscle cells vasculature we studied the effect of the “less- calcemic” analog of 1,25(OH)2D3 (1,25D); JK 1624F2-2 (JKF) in Femarelle the presence of selective estrogen modulator femarelle (F), the phytoestrogen daidzein (D) and estradiol-17b (E2) 1,25D on 3[H] thymidine incorporation (DNA synthesis) and creatine kinase specific activity (CK) in human umbilical JKF artery vascular smooth muscle cells (VSMC). F, D and E , stimulated DNA synthesis at low concentrations, and 1OHase 2 inhibited it at high concentrations. All estrogen-related compounds increased CK dose- dependently. Daily treatment with JKF (1 nM for 3 days) resulted in decreased DNA synthesis, increased CK and up- regulation of the stimulation of DNA synthesis by low estrogen-related hormones whereas D- and E2- mediated inhibition of cell proliferation was abolished by JKF. In contrast, inhibition of cell proliferation by F could not be blocked by JKF. JKF also up-regulated the stimulatory effects on CK by F, E2 and D.