Effectiveness of low dose cyproterone acetate compared to standard dose in feminizing hormone treatment: a single institutional retrospective pilot study.

IF 2.6 3区医学 Q1 MEDICINE, GENERAL & INTERNAL Sexual Medicine Pub Date : 2024-09-21 eCollection Date: 2024-08-01 DOI:10.1093/sexmed/qfae063

Sira Korpaisarn, Jiraporn Arunakul, Kewalin Chaisuksombat, Teerapong Rattananukrom

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Abstract

Background: Data regarding the effectiveness of low-dose cyproterone acetate (CPA) in testosterone suppression as feminizing hormone therapy (FHT) in individuals assigned male at birth (AMAB) are sparse.

Aim: To assess the effectiveness in testosterone suppression using low-dose CPA (<25 mg/day) compared to standard-dose CPA (25-50 mg/day) in FHT.

Methods: A retrospective cohort study of 59 individuals AMAB using CPA was done at a tertiary care center in Bangkok, Thailand between January 2014 and July 2022.

Outcomes: The main outcomes included a median time when the testosterone was suppressed (<50 ng/dL), the proportion of individuals AMAB who achieved the targeted testosterone level at 3 months, and the testosterone level at each follow-up. Changes in clinical data were assessed.

Results: Among 59 individuals AMAB, 37 initiated CPA with available testosterone levels at the 3-month follow-up. Twenty-two individuals AMAB started with low-dose CPA (12.5 mg/day), and 15 individuals AMAB started with standard-dose CPA. The median time to reach targeted testosterone was 3 months in both groups (adjusted hazard ratio 0.60, P = .489). At 3 months, 72.7% of those on low-dose CPA and 86.7% of those on standard-dose CPA achieved targeted testosterone (adjusted relative risk 0.85, P = .606). Testosterone levels at all follow-up visits were not significantly different. The standard dose group had higher high-density lipoprotein cholesterol (HDL-C) but lower low-density lipoprotein cholesterol (LDL-C) and alanine aminotransferase (ALT).

Clinical translation: This study supports a paradigm shift toward using lower-dose CPA in FHT.

Strengths and limitations: This is one of a few studies showing the effectiveness of low-dose CPA in testosterone suppression within 3 months. Limitations include a small sample size and missing data.

Conclusions: Testosterone suppression is comparable between CPA 12.5 mg/day and the standard dose in FHT.

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在女性化激素治疗中，低剂量醋酸环丙孕酮与标准剂量的疗效比较：一项单一机构回顾性试验研究。

背景：有关低剂量醋酸环丙孕酮（CPA）作为女性化激素疗法（FHT）抑制出生时即被指派为男性的个体（AMAB）睾酮的有效性的数据很少：2014年1月至2022年7月期间，泰国曼谷的一家三级医疗中心对59名使用CPA的AMAB患者进行了一项回顾性队列研究：主要结果包括睾酮被抑制的中位时间（结果：在 59 名 AMAB 患者中，37 人开始接受 CPA 治疗，3 个月随访时睾酮水平尚可。22名AMAB患者开始使用低剂量CPA（12.5毫克/天），15名AMAB患者开始使用标准剂量CPA。两组达到目标睾酮的中位时间均为 3 个月（调整后危险比为 0.60，P = .489）。3 个月后，72.7% 的低剂量 CPA 患者和 86.7% 的标准剂量 CPA 患者达到了目标睾酮水平（调整后相对风险为 0.85，P = 0.606）。所有随访的睾酮水平均无显著差异。标准剂量组的高密度脂蛋白胆固醇（HDL-C）较高，但低密度脂蛋白胆固醇（LDL-C）和丙氨酸氨基转移酶（ALT）较低：这项研究支持了在 FHT 中使用低剂量 CPA 的模式转变：这是少数几项显示低剂量 CPA 在 3 个月内有效抑制睾酮的研究之一。局限性包括样本量小和数据缺失：睾酮抑制效果在12.5毫克/天的CPA和标准剂量的FHT中不相上下。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sexual Medicine MEDICINE, GENERAL & INTERNAL-

CiteScore

5.40

自引率

0.00%

发文量

103

审稿时长

22 weeks

期刊介绍： Sexual Medicine is an official publication of the International Society for Sexual Medicine, and serves the field as the peer-reviewed, open access journal for rapid dissemination of multidisciplinary clinical and basic research in all areas of global sexual medicine, and particularly acts as a venue for topics of regional or sub-specialty interest. The journal is focused on issues in clinical medicine and epidemiology but also publishes basic science papers with particular relevance to specific populations. Sexual Medicine offers clinicians and researchers a rapid route to publication and the opportunity to publish in a broadly distributed and highly visible global forum. The journal publishes high quality articles from all over the world and actively seeks submissions from countries with expanding sexual medicine communities. Sexual Medicine relies on the same expert panel of editors and reviewers as The Journal of Sexual Medicine and Sexual Medicine Reviews.