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Estroprogestinic pill normalizes IGF-I levels in acromegalic women

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Abstract

In some acromegalic patients medical treatment does not succeed in normalizing GH/IGF-I values. Data showing IGF-I suppression in acromegaly by estrogen and by tamoxifen use prompted us to reevaluate the effects of estro-progestins (EP) supplementation on GH/IGF-I levels in acromegalic women resistant or only par-tially sensitive to medical treatment. Eight active acromegalic women (30–52 yr, 4 with regular menses) entered a prospective open pilot study. Three of them, resistant to medical treatment, were off therapy; the remaining five, partially sensitive, maintained it at the maximally effective dosages throughout the study. Patients were treated with a triphasic pill (ethynil-estradiol 30–40–30 μg/day and desogestrel 50–70–100 mg/day) for 13±7 months. IGF-I levels fell from 512 (median, interquartile 436–657) μg/l to 282 (244–526) μg/l (p=0.0414); the decrease was observed in 6 patients (75%), and normal values were reached in 4 (50%). GH levels did not change [basal 7.6 (6.2–8.6) μg/l, final 7.6 (6.5–8.3) μg/l]. Effectiveness of treatment was not dependent on concomitant anti-GH treatment or gonadal status. In all patients IGF-I levels re-increased after EP withdrawal. This pilot study shows a marked IGF-I lowering effect of pill in acromegalic women, and warrants a prospective randomized study in patients resistant or partially sensitive to other medical treatments.

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Authors and Affiliations

  1. Division of Endocrinology, Niguarda Hospital, Viale Ezio 5, I-20149, Milano, Italy

    Renato Cozzi, M. Barausse & R. Attanasio

  2. Division of Neurosurgery, Neurologic Institute Carlo Besta, Milan, Italy

    S. Lodrini & G. Lasio

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  1. Renato Cozzi
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  2. M. Barausse
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  3. S. Lodrini
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  4. G. Lasio
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  5. R. Attanasio
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Correspondence to Renato Cozzi.

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Cozzi, R., Barausse, M., Lodrini, S. et al. Estroprogestinic pill normalizes IGF-I levels in acromegalic women. J Endocrinol Invest 26, 347–352 (2003). https://doi.org/10.1007/BF03345183

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