Calcium homeostasis, bone metabolism and safety aspects during long-term treatment with a GnRH agonist.
Thirty-five women with symptomatic fibroids were treated with monthly injections of 3.2 mg microcapsulated D-Trp-6-LHRH for 6 months. During treatment serum 17 beta-oestradiol levels decreased, falling to castration levels associated with a reduction in the volume of the fibroids. In 16 patients a complete calcium homeostasis and bone metabolism work-up was carried out during treatment and subsequently for a 6-month follow-up period. Bone mineral content (BMC) and Compton bone densitometry readings remained unchanged. There were significant increases in serum calcium phosphate and alkaline phosphatase concentrations. A slight although not significant increase was observed in osteocalcin and parathyroid hormone (PTH) serum levels. Serum 1,25(OH)2D3 values decreased significantly after 3 months of treatment. Urinary hydroxyproline/creatinine and calcium/creatinine ratios as well as 24-h urinary calcium values increased significantly during the treatment period but decreased rapidly to pretreatment values after 3 months in the follow-up period. The endocrine changes induced by the GnRH-agonist treatment were associated with reversible biochemical signs of increased bone turnover and no significant changes in bone mass, suggesting that the treatment can be administered safely for a period of 6 months in patients with oestrogen-dependent diseases.
Eckstein
N
N
Timsit Institute of Reproductive Endocrinology, Tel Aviv Souraski Medical Center, Israel.
Foldes
J
J
Feinstein
Y
Y
Vagman
I
I
Eshel
A
A
Steinberg
R
R
Statter
M
M
Limor
R
R
Ayalon
D
D
D000328:Adult; D015519:Bone Density / Q000187:drug effects; D001842:Bone and Bones / Q000378:metabolism*; D002118:Calcium / Q000378:metabolism*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006706:Homeostasis / Q000187:drug effects*; D006801:Humans; D007889:Leiomyoma / Q000188:drug therapy / Q000378:metabolism; D008875:Middle Aged; D017329:Triptorelin Pamoate; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000378:metabolism
D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D002118:Calcium