Primary aldosteronism treated by trilostane (3 beta-hydroxysteroid dehydrogenase inhibitor).
The practicability and tolerability of trilostane, a competitive inhibitor of 3 beta-hydroxysteroid-delta 5-dehydrogenase, for the therapy of primary aldosteronism was assessed in 1 patient with aldosterone-producing adenoma (APA) and 3 subjects with idiopathic adrenal hyperplasia (IHA). Trilostane afforded reduction of plasma levels of aldosterone, progesterone, deoxycorticosterone, 17-OH progesterone, cortisol, delta 4-androstenedione, and urinary excretion of 17-hydroxycorticosteroid. Conversely, circulating levels of dehydroepiandrosterone, dehydroepiandrosterone sulfate, and urinary excretion of 17-ketosteroids were increased following this drug therapy. Suppression of mineralo- or glucocorticoid biosynthesis was accompanied by an increase in plasma renin activity. One patient with APA or 3 subjects with IHA showed slight or remarkable improvement of hypertension and hypokalemia. Based on these findings, efficacy and tolerability of trilostane appear to aid in the treatment of IHA.
Nakada
T
T
Kazama
T
T
Koike
H
H
Yoshikawa
M
M
Ishikawa
S
S
Katayama
T
T
D015065:17-Hydroxycorticosteroids / Q000652:urine; D000236:Adenoma / Q000150:complications; D000310:Adrenal Gland Neoplasms / Q000150:complications; D000312:Adrenal Hyperplasia, Congenital / Q000150:complications; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000735:Androstenedione / Q000097:blood; D003687:Dehydroepiandrosterone / Q000097:blood; D003900:Desoxycorticosterone / Q000097:blood; D013196:Dihydrotestosterone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D006913:Hydroxysteroid Dehydrogenases / Q000037:antagonists & inhibitors*; D006929:Hyperaldosteronism / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010086:Oxidative Phosphorylation Coupling Factors / Q000627:therapeutic use*; D011374:Progesterone / Q000097:blood; D011863:Radioimmunoassay; D012084:Renin-Angiotensin System / Q000187:drug effects; D013739:Testosterone / Q000097:blood
D015065:17-Hydroxycorticosteroids; D010086:Oxidative Phosphorylation Coupling Factors; D013196:Dihydrotestosterone; D013739:Testosterone; D000735:Androstenedione; D003900:Desoxycorticosterone; D003687:Dehydroepiandrosterone; D011374:Progesterone; D004958:Estradiol; D000324:Adrenocorticotropic Hormone; D006913:Hydroxysteroid Dehydrogenases; C009954:trilostane