Bicalutamide and third-generation aromatase inhibitors in testotoxicosis.
Testotoxicosis, a form of gonadotropin-independent precocious puberty, results from an activating mutation of the luteinizing hormone receptor expressed in testicular Leydig cells. Affected males experience early testosterone secretion, virilization, advancing bone age, and resultant short stature. Recently, the use of combination therapy with a potent antiandrogen agent (bicalutamide) and a third-generation aromatase inhibitor (anastrozole or letrozole) was reported to yield encouraging short-term results. We present here the results of longer-term treatment (4.5 and 5 years) with this combination therapy in 2 boys who demonstrated that it is well tolerated, slows bone-age advancement in the face of continued linear growth, and prevents progression of virilization.
Lenz
Anne M
AM
Department of Pediatric Endocrinology, Diabetes, and Metabolism, University of South Florida, All Children's Hospital, 501 Sixth Ave S, Box 6900, St Petersburg, FL 33701, USA. alenz@health.usf.edu
Shulman
Dorothy
D
Eugster
Erica A
EA
Rahhal
Samar
S
Fuqua
John S
JS
Pescovitz
Ora H
OH
Lewis
Katherine A
KA
D000077384:Anastrozole; D000726:Androgen Antagonists / Q000627:therapeutic use*; D000813:Anilides / Q000627:therapeutic use*; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D002675:Child, Preschool; D006801:Humans; D000077289:Letrozole; D008297:Male; D009570:Nitriles / Q000627:therapeutic use*; D011629:Puberty, Precocious / Q000097:blood / Q000209:etiology*; D013739:Testosterone / Q000097:blood; D014105:Tosyl Compounds / Q000627:therapeutic use*; D014230:Triazoles / Q000627:therapeutic use*
D000726:Androgen Antagonists; D000813:Anilides; D047072:Aromatase Inhibitors; D009570:Nitriles; D014105:Tosyl Compounds; D014230:Triazoles; D000077384:Anastrozole; D013739:Testosterone; D000077289:Letrozole; C053541:bicalutamide