Depot medroxyprogesterone acetate use and periodontal health in 15- to 44-year-old US females

Background: It has been suggested that progestins may have an inflammatory component and/or increase in prostaglandin synthesis. Thus, extended progestin use may be associated with higher risk of periodontal diseases. This study investigates the association between depot medroxyprogesterone acetate (DMPA) injectable contraception and the prevalence of periodontal diseases among US premenopausal females. Methods: Data for this cross‐sectional analysis comes from the 1999 to 2004 National Health and Nutrition Examination Surveys. This analysis includes 4,460 US females (15 to 44 years of age) with complete DMPA usage and periodontal status data. Results: Current and past DMPA use was 4.1% and 12.0%, respectively. The prevalence of gingivitis was 53.9% for females who reported having used DMPA compared with 46.1% for DMPA never‐users. Females taking DMPA were more likely to be young, single, and non‐white, have a history of smoking, have lower levels of education and income, and have ≥1 live births and were less likely to visit the dentist. Using logistic regression, DMPA use was associated with an increased risk of gingivitis (odds ratio [OR] =1.7; 95% confidence interval [CI] = 1.09 to 1.67) and periodontitis (DMPA, OR = 1.49; 95% CI = 1.01 to 2.22) after adjusting for age, race, education, poverty income ratio, dental care use, and smoking status. A significant interaction between smoking status and DMPA use was also found (P = 0.029). Conclusions: This study suggests that DMPA use may be associated with periodontal diseases. Additional investigation is warranted as a result of the disproportionate usage of DMPA among low‐income populations who are at an increased risk for poor dental health.     

食管癌同步放化疗中应用大剂量甲羟孕酮的临床研究

目的研究在食管癌同步放化疗中应用大剂量的甲羟孕酮的临床效果。方法将2007年6月至2013年6月收治的中晚期食管癌患者80例,按照随机数字表法分为试验组和对照组,每组各40例。试验组给予放化疗的同时应用甲羟孕酮,250 mg每日一次;对照组单用同期放化疗治疗的方案。观察两组治疗的临床效果和不良反应。结果试验组的有效率(97.5%)明显的高于对照组(87.5%),差异具有统计学意义(P0.05);食欲与疼痛的变化方面试验组改善效果优于对照组,差异具有统计学意义(P0.05)。治疗后两组体重,血浆白蛋白之间的差异变化明显,试验组改善优于对照组(P0.05)。不良反应如白细胞下降Ⅱ度以上、血红蛋白下降Ⅱ度以上、胃肠道反应Ⅱ度以上所占患者比率试验组均显著低于对照组,差异具有统计学意义(P0.05)。结论食管癌同步放化疗中应用大剂量的甲羟孕酮不仅可以明显提高治疗的效果,同时也可以减少或者改善不良反应事件的发生。     

甲羟孕酮辅助老年性肺癌化疗生存状况的临床观察

目的观察甲羟孕酮在老年性肺癌化疗期间及化疗后,对食欲、进食状况、体重、胃肠道反应以及全身情况的辅助作用。方法观察50例老年性肺癌化疗加甲羟孕酮辅助治疗病人与50例单纯化疗病人治疗期间及化疗后,食欲、食量、体重变化、胃肠道反应以及全身情况变化的比较。结果治疗组82％食欲有改善,78％食量增加,34％化疗期间无明显胃肠反应,KPS评分增加大于10分占66％。单化组食欲,食量无一例改善,仅4％无恶心、呕吐,KPS评分大于10分占6％,差异有显著性。结论甲羟孕酮辅助老年性肺癌化疗作用明显,有提高食欲,降低化疗胃肠道反应,提高生活质量的作用。     

醋酸甲孕酮改善晚期癌症患者化疗期生活质量的临床研究

目的 :观察患者口服 5 0 0mg醋酸甲孕酮改善化疗期生活质量疗效。方法 :2 33例各种肿瘤患者随机分成两组。治疗组 117例 ,化疗期联用甲孕酮 5 0 0mg/日 ,6～ 8周为一观察周期。对照组 116例 ,采用单独化疗。结果 :治疗组中 10 1例 (86 2 % )食欲增加 ,73例 (6 2 4 % )体重增加 ,91例 (77 8% )疼痛缓解 ,明显优于对照组 ,P <0 0 0 5。结论 :醋酸甲孕酮在改善晚期癌症患者生活质量方面有较好的疗效 ,且毒副作用不明显。     

Oral medroxyprogesterone acetate in the treatment of metastatic breast cancer

Summary Thirty-nine evaluable, postmenopausal patients with metastatic breast carcinoma were treated with medroxyprogesterone acetate administered orally at daily doses of 800 mg/day in 29 patients and 400 mg/day in 10 patients. One patient experienced a complete remission and 16 had partial remissions for an objective remission rate of 44%. There was no apparent difference in response between the two dose levels. Median remission duration was 8 months, and median survival for the whole group is expected to exceed 18 months. Increased appetite (66%) and weight gain (97%) were the most common side effects, followed by fluid retention, muscle cramps, and increased blood pressure. Performance status improved and white blood cell and platelet counts increased in the majority of patients. Medroxyprogesterone acetate is an effective hormonal agent in the treatment of metastatic breast cancer.     

Significance of p27 as a predicting marker for medroxyprogesterone acetate therapy against endometrial endometrioid adenocarcinoma

Abstract.   Watanabe J, Watanabe K, Jobo T, Kamata Y, Kawaguchi M, Imai M, Okayasu I, Kuramoto H. Significance of p27 as a predicting marker for medroxyprogesterone acetate therapy against endometrial endometrioid adenocarcinoma. Int J Gynecol Cancer 2006; 16(Suppl. 1): 452–457.
We reported that p27 induced by medroxyprogesterone acetate (MPA) may be involved in the progestin-induced growth suppression of human endometrial adenocarcinoma cells. This study aimed at investigating whether p27 expression could be a predicting marker to evaluate the effectiveness of MPA therapy. The clinical responses of 15 patients with endometrial carcinoma treated with MPA were examined. p27 expression was evaluated by immunohistochemical staining. Percentage of positive nuclear staining was expressed as a strongly positive (SP) labeling index (LI). Before MPA treatment, SP LIs in the effective and noneffective groups were 22.6 ± 14.3% and 9.1 ± 9.2%. At 1–6 weeks in the MPA treatment, SP LIs increased in both groups and were significantly higher than those before the therapy. At 7–12 weeks, SP LIs in both groups decreased to the level of pretherapy. At 13–18 weeks, SP LIs in the effective group were 14.9 ± 5.7%, whereas in the noneffective group, 1.1 ± 2.0%. The former was significantly higher than the latter. p27 expression could predict the effectiveness of MPA treatment for endometrial carcinoma at an early stage of the 4-month period in MPA therapy and could be a useful predicting marker for MPA.     

Progestin stimulates the biosynthesis of fibronectin and accumulation of fibronectin mRNA in human endometrial stromal cells.

Fibronectin is a major component of decidual basement membrane. In the present study, we have investigated the effect of progestin on the synthesis and secretion of fibronectin in human endometrial stromal cells. Stromal cells were isolated during the menstrual cycle and cultured in RPMI-1640 with 2% fetal calf serum supplemented with progesterone or medroxyprogesterone acetate (MPA) in a long-term culture system. Indirect immunofluorescent staining showed that fibronectin was uniformly distributed in the intracellular and extracellular regions of stromal cells treated with MPA for 14 days. The biosynthesis and secretion of this protein and the accumulation of cellular fibronectin mRNA were studied after various culture periods. Cells were pulse-labelled with [35S]methionine to determine the amount of newly synthesized fibronectin secreted into the culture medium. A monoclonal antibody (Mab) identified human fibronectin on SDS-polyacrylamide gel electrophoresis (SDS-PAGE), showing a predominant band (Mr 230-250 kDa) which migrated with authentic fibronectin run in parallel. In six endometrial specimens, the amount of radioactivity incorporated as [35S]fibronectin was increased by progestin. Maximal stimulation occurred after 6 days treatment with MPA. Culture beyond 16 days reduced the rate of synthesis and secretion to 40% of the maximum. The effect of progestin was dose dependent with 0.02, 0.2 and 1 microM progesterone, producing 2.0, 3.8 and 11-fold increases respectively, over the control. Medroxyprogesterone acetate was more effective than progesterone, the maximal response (10-fold increase) being achieved at 0.02 microM MPA.(ABSTRACT TRUNCATED AT 250 WORDS)     

Oral High-Dose Progestins as Treatment for Advanced Breast Cancer

Fifty-two postmenopausal, previously treated advanced breast cancer patients who received oral high-dose progestins (medroxyprogesterone acetate [MPA] and/or megestrol acetate [MA]) were retrospectively reviewed. MPA was given to 45 patients and MA to 17 (10 earlier treated with MPA); 48 were evaluable for clinical response to progestin treatment, 43 for MPA and 5 for MA. Two complete responses and 10 partial responses (25%) with median duration of 9.5 months were seen. Forty percent of the patients obtained stable disease ≥6 months with a median duration of 8.0 months. in patients with estradiol receptor positive (n=31) and estradiol and progesterone receptor positive (n=19) tumors the response rates were 35% and 37% respectively. No differences in serum levels of MPA or MA were observed in the different responding groups. the serum levels of MA were twice as high as MPA in spite of a dose of 160 mg/day of MA compared to 1000 mg/day of MPA. A long disease-free interval, and positive receptor status of primary or metastatic lesions seemed to predict response to endocrine therapy even late in a therapeutic sequence. Side effects occurred in 11/45 (24%) of MPA treated patients and in 1/15 (7%) of MA treated patients. No difference in serum levels of MPA was found between patients with side effects and patients without side effects.     

Spermatogenesis in men treated with injections of medroxyprogesterone acetate combined with testosterone enanthate

The effects of a combination of medroxyprogesterone acetate and testosterone enanthate, on the exocrine and endocrine testicular function were examined in adult men. The treatment was carried out with 2 different regimens and lasted for 8 months. Group I received an initial injection of 1000 mg medroxyprogesterone acetate and 500 mg testosterone enanthate followed by monthly maintenance dose of 150 mg medroxyprogesterone acetate and 500 mg testosterone enanthate. In group II, after an initial high dose of 1000 mg medroxyprogesterone acetate and 250 mg testosterone enanthate treatment was given as biweekly injections of 75 mg medroxyprogesterone acetate and 250 mg testosterone enanthate. Complete spermatogenic arrest of variable duration was achieved in all 9 subjects enrolled. Restoration of spermatogenesis occurred in both groups, in a few cases during the treatment, and there was a delay of full recovery of sperm counts up to 5 months after cessation of therapy. None of the subjects enrolled in this study complained of decrease in libido or change in sexual behaviour. Clinical evaluation and measurements of various urine and serum components revealed no significant changes during the treatment period. The dosage and the different administration schedule of the hormone combination described here was inadequate to maintain azoo-spermia in all subjects during treatment.