title: An open trial of long-term testosterone suppression in spinal and bulbar muscular atrophy.
abstract: BACKGROUND
  We investigated the long-term effects of leuprorelin on leg-muscle strength in spinal and bulbar muscular atrophy (SBMA). We hypothesized that testosterone suppression by leuprorelin would prevent the progression of muscle weakness.
  
  
  METHODS
  In a prospective, long duration, open trial, 16 SBMA patients underwent medical castration with leuprorelin for 3.5 years. Chlormadinone was coadministered initially to prevent a testosterone surge. The strength of knee extension and flexion were quantitated using a torque machine.
  
  
  RESULTS
  Our hypothesis was rejected. The leg strength measures decreased significantly with the mean reduction of 22.3-27.8%. In a post hoc analysis, the leg strength of 4 patients with higher pretreatment baseline total testosterone levels and short disease duration of 1-6 years were stronger at baseline and decreased by only 12.3-15.7% after treatment.
  
  
  CONCLUSIONS
  Leuprorelin was not effective in this small long-term treatment trial in SBMA. The possibility that earlier treatment might be beneficial may deserve further study.
authors.affiliation: Department of Neurology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Yokota
authors.forename: Rie
authors.initials: R
authors.lastname: Amao
authors.forename: Takashi
authors.initials: T
authors.lastname: Maeno
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Haga
authors.forename: Masataka
authors.initials: M
authors.lastname: Taguri
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohtsu
authors.forename: Yaeko
authors.initials: Y
authors.lastname: Ichikawa
authors.forename: Jun
authors.initials: J
authors.lastname: Goto
authors.forename: Shoji
authors.initials: S
authors.lastname: Tsuji
mesh_terms: D000328:Adult; D000726:Androgen Antagonists / Q000627:therapeutic use*; D002715:Chlormadinone Acetate / Q000627:therapeutic use; D003692:Delayed-Action Preparations / Q000627:therapeutic use; D018450:Disease Progression; D006801:Humans; D007717:Knee; D016729:Leuprolide / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000187:drug effects*; D018908:Muscle Weakness / Q000188:drug therapy; D020966:Muscular Disorders, Atrophic / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D003692:Delayed-Action Preparations; D002715:Chlormadinone Acetate; D016729:Leuprolide