17 alpha-hydroxyprogesterone caproate.
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Animals↗
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[Effect of 17-alpha-hydroxyprogesteronecapronate on sodium excretion and the renin-angiotensin-aldosterone-system in humans].
In seven healthy male subjects, a natriuretic effect of 17 alpha-hydroxyprogesterone caproate (17 alpha-OHPC) was demonstrated. Three of these subjects were kept on an uncontrolled diet and were examined over a period of 12 days. To the remaining four subjects, a single dose of 250 mg 17 alpha-OHPC was given intramuscularly after four days of intake of a chemically defined diet (Vivasorb). In this second test procedure, blood samples were taken in the recumbent position every two hours throughout a period of 12 h after the injection. For two more days and during the days before the administration of 17 alpha-OHPC, blood was taken at 8 a.m. before getting up from bed in same intervals, urine was collected for analysis of sodium and potassium excretion. During the first 12 h after the injection of 17 alpha-OHPC, the urinary sodium/potassium ratio significantly increased in all subjects. Plasma renin activity showed no characteristic changes at this time, whereas the plasma concentrations of aldosterone and cortisol decreased. The decrease of cortisol concentration started immediately after the injection and was more pronounced than that of plasma aldosterone. During the following 36 h, renin activity as well as aldosterone and cortisol concentrations in plasma showed an increase; in contrast, the sodium/potassium ratio decreased. On the basis of these results, the following effects of 17 alpha-OHPC are discussed: (1) an acute natriuresis which may be due to a competitive inhibition of aldosterone at the renal tubules, and (2) an inhibition of pituitary ACTH secretion or of adrenal steroid biosynthesis.
Adult↗
High-risk prematurity--progestin treatment and steroid studies.
Studies have been undertaken regarding the efficacy and modus operandi of 17 alpha-hydroxyprogesterone caproate (17 alpha-OHP-C) in preventing premature labor in high-risk patients. In a total of 70 patients, the treated patient population had a prematurity rate (12.8%) and a perinatal mortality rate (5%) which were significantly lower than those of the total placebo or untreated patient group (40.9 and 25%, respectively). In addition, sequential plasma steroid values were determined in 21 patients, 10 of whom delivered prematurely. The results indicate that low plasma progesterone (P) and 17 alpha-hydroxyprogesterone (17 alpha-OHP) levels precede the onset of preterm labor by weeks. Successful treatment with 17 alpha-OHP-C was characterized by elevated P levels. Plasma estradiol (E2) and cortisol (C) values did not vary with time of delivery or treatment. These findings support the progesterone block theory as an important mechanism affecting preterm delivery in this high-risk population.
Estradiol↗
Progestogen administration in pregnancy may prevent preterm delivery.
Two recently published meta-analyses of controlled trials of a wide variety of progestational agents, used in pregnancy (Daya 1989; Goldstein et al. 1989), prompted this third meta-analysis of placebo-controlled trials involving the prophylactic use of a single agent, 17 alpha-hydroxyprogesterone caproate. Of seven relevant published reports of controlled trials, six had involved women considered to be a high risk of miscarriage or preterm birth. This analysis provides no support for the view that 17 alpha-hydroxyprogesterone caproate protects against miscarriage, but suggests that it does reduce the occurrence of preterm birth. The latter effect was reflected in a reduced rate of low birthweight babies, but not in a statistically significant reduction in perinatal mortality and morbidity. The difference between this meta-analysis and the two earlier meta-analyses illustrates the problems both of selective sub-grouping and of comprehensive pooling of data from small trials.
17 alpha-Hydroxyprogesterone Caproate↗
The effect of 17 alpha-hydroxyprogesterone caproate/oestradiol valerate on the development and outcome of early pregnancies following in vitro fertilization and embryo transfer: a prospective and randomized controlled trial.
A prospective and randomized study was performed to investigate the effect of supportive hormones on the development and outcome of early pregnancies following in vitro fertilization and embryo transfer. Immediately after pregnancies were confirmed endocrinologically on day 15 after oocyte collection, 17 alpha-hydroxyprogesterone caproate and oestradiol valerate (PC/EV) was administered to half of the patients in a randomly controlled trial. One group received supportive treatment until the twelfth week of gestation, whereas the other group received no treatment at all. Both groups were followed up by measurements of serum levels of human chorionic gonadotrophin (HCG), oestradiol and progesterone every three days until day 35, when a first ultrasound examination was carried out to confirm fetal vitality. Subsequently, pregnancies were monitored sonographically at regular intervals. In cases of miscarriage, dilatation and curettage was performed and histology analysed. A total of 120 pregnant patients entered the study: 55 of them received hormone treatment and 65 patients were controls. Within the treatment group 48 (89%) clinically ongoing pregnancies were observed, five (9%) miscarriages occurred after the seventh week of gestation and one preclinical pregnancy was noted. In the control group, 38 (59%) ongoing pregnancies were observed, nine (14%) miscarriages occurred and 17 (27%) preclinical pregnancies were recorded. Two ectopic pregnancies, one in each group, were excluded from evaluation. A significantly higher percentage of pregnancies were intact at 7 weeks of gestation after treatment with PC/EV (p less than or equal to 0.01).
17 alpha-Hydroxyprogesterone Caproate↗
Serum progesterone and estradiol in pregnant women selected for progestagen treatment.
Patients with two or more previous spontaneous second trimester abortions and vaginal cytology indicating a poor progestational response in current pregnancies were selected for treatment with Provera (medroxyprogesterone acetate) and/or Delalutin (17 alpha-hydroxyprogesterone caproate). Serum was examined serially for progesterone (P) and estradiol (E) by radioimmunoassay. Serum from 174 untreated patients with no known complications ranging from 6--40 weeks gestation provided normal distribution data. Of 14 progestagen-treated patients, four aborted during the second trimester. These all had chronically low (greater than 50% of observations were less than 1 standard deviation of the normal population) or falling P/E ratios. The rest delivered normal full-term infants although five of the 10 had chronically low P, seven had chronically low P/E ratios, and in one other P/E was falling. Chronically high E contributed to the low P/E ratio in three cases. Thus, these selected cases with poor obstetrical histories demonstrated steroid patterns outside the +/- 1 standard deviation range, although the steroid levels were still within the normal range. Serum progesterone and estradiol analysis may eventually be useful in identifying patients who will best respond to progestagen treatment.
Abortion, Habitual↗
Effect of oxyprogesterone caproate, tamoxifen and their combination on the level of steroid hormone receptors in the tumor, and some parameters of the reproductive system in patients with endometrial cancer.
The results of preoperative use of oxyprogesterone caproate (OPC), Tamoxifen and their combination in 165 patients suffering from primary endometrial carcinoma are presented. It was shown that Tamoxifen was able to increase concentrations cytoplasmatic receptors to progesterone in the tumor. The incidence of specific hormonal pathomorphosis in the tissue of the tumor in patients who received a combination of OPC and Tamoxifen was significantly higher (80% of cases) as compared to the separate use of OPC (60%) or Tamoxifen (57%).
17 alpha-Hydroxyprogesterone Caproate↗
A randomized trial of adjuvant progestagen in early endometrial cancer.
A randomized, controlled trial was designed to determine whether adjuvant progestagen therapy improves survival in patients with Stage I or Stage II endometrial cancer. After surgery, 1148 patients were randomly assigned to adjuvant treatment with progesterone or were given no additional therapy. The duration of follow-up ranged from 42 to 132 months (median follow-up, 72 months). Crude survival and relapse rates were similar for both groups. Death due to intercurrent disease was higher in the progesterone group (P = 0.04). The median survival of the group of patients with cancer-related death was higher in the progestagen group than in the control group (30 and 22 months, respectively; P = 0.03). In 461 high-risk patients, a tendency towards fewer cancer-related deaths and a better disease-free survival in the treatment group was observed, but crude survival was unchanged. We conclude that there is little to gain from adjuvant progestagen therapy in patients with low-risk endometrial cancer, and that further studies are needed in high-risk patients.
17 alpha-Hydroxyprogesterone Caproate↗
Ovum donation by sisters in ovarian failure: simplified priming and early withdrawal of exogenous support.
Two cases of successful pregnancy and delivery by patients with ovarian failure are reported. In both cases ova were donated by the sister of the patient. A high degree of success (two pregnancies in three attempts) is discussed, as is the significance of simplified pretransfer "priming" and very early withdrawal of exogenous hormonal support.
17 alpha-Hydroxyprogesterone Caproate↗
Effect of excipients on the stability of levothyroxine sodium tablets.
Levothyroxine sodium tablets from two different manufacturers were analysed using the USP-NF method of analysis, a stability-indicating high pressure liquid chromatographic (HPLC) procedure. The results indicate that one particular manufacturer's 0.2-mg pink tablets contain some excipient(s) which act as a catalyst to hasten decomposition after extraction of levothyroxine for analysis. The same tablets from a different batch showed an additional long peak in the chromatogram, which indicated that the excipient(s) may have been changed. The same manufacturer has also used three different types of bottles/lids for the same product during the last year. Good manufacturing practice requires that new compatibilities/stability studies be conducted to assure the quality of the product. Ongoing stability studies are required by the Food and Drugs Administration (FDA). The use-life of 0.2-mg pink tablets of this manufacturer may be short.
17 alpha-Hydroxyprogesterone Caproate↗
[Are gestagens suitable for lowering the membrane potential of the uterine muscle and eliminating the need for beta-mimetics?].
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17 alpha-Hydroxyprogesterone Caproate↗
Changes in fibronectin production in rat liver during cirrhotic evolution due to treatment with CCl4 and steroid hormones: correlation with plasmatic fibronectin.
Previous our studies showed that some steroid hormones, as pure crystalline Progesterone (pPc) and 17-alpha-hydroxyprogesterone capronate (17 alpha HPC) heightened the cirrhogenic action produced in rat liver by carbon tetrachloride. Medroxyprogesterone (MPA), however, did not appear to promote cirrhosis, but increased just steatosis. In the present paper, we have studied the above mentioned steroid hormones for their possible capability of inducing changes in plasma fibronectin concentration. For this purpose, the soluble plasma fibronectin level was measured in female rats 45 days after CCl4-induced cirrhosis, and it was compared with the insoluble fibronectin of liver (detected by immunostaining) and the collagen content in the organ. The results obtained show that, after treatment with CCl4 and MPA, both plasma and liver fibronectin content strongly increases, whereas liver collagen content lowers. However, after treatment with CCl4 alone or in association with the other two steroid hormones, any changes in fibronectin content is not observable, but, on the contrary, is evident a heightened collagen production associated with a cirrhotic change of liver.
17 alpha-Hydroxyprogesterone Caproate↗
[Oxyprogesterone capronate in the treatment of menstrual epilepsy].
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17 alpha-Hydroxyprogesterone Caproate↗
[Progesterone test in the diagnosis of stenosis of the ureteropelvic segment].
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17 alpha-Hydroxyprogesterone Caproate↗
[The conservative treatment of kidney cancer in middle-aged and elderly patients].
Late results of conservative management were investigated in 102 patients with renal carcinoma. Their ages were 60 to 90. A symptomatologic therapy alone was used in the management of 60 patients, 38 were treated with hydroxyprogesterone capronate and 4 with nolvadex. All the patients suffered from concomitant diseases. The refusals of operative treatment were because of such causes as: 1) extension of the tumor process in 29; 2) severe intercurrent diseases in 41; 3) cancer of a single, single-functioning kidney or the both kidneys in 7; 4) the patients' refusals in 25 patients. After the described treatment 71.6% of them lived 1 year, 36.8%-3, and 26.2%-5 years, that was quite comparable with the postoperative results. Prognostically beneficial treatment criteria were: a patient's age of 70 or more years, the stage T1-2N0M0V0, asymptomatic course of the disease, absence of anemia, accelerated erythrocyte sedimentation rate (ESR) more than 40 mm/h; the tumor size less than 10 cm. The most unfavourable prognostic criteria were: T4 stage of the disease, decrease of a hemoglobin level lees than 80 g/l, tumor size more than 10 cm. No one of the 41 patients who had had at least of these signs survived over 3 years. The use of hydroxyprogesterone capronate had no advantages over the symptomatic therapy and did not prolong a patient's life. A 5-year survival of patients managed on hormonal therapy was 22%, on the symptomatic one, 27.1%.(ABSTRACT TRUNCATED AT 250 WORDS)
17 alpha-Hydroxyprogesterone Caproate↗
[Progestins in combined treatment of endometrial cancer].
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17 alpha-Hydroxyprogesterone Caproate↗
Application of thymic factor "Thymalin" in complex treatment of endometrial cancer patients.
Indications have been received of cell immunity in 111 primary endometrial cancer patients in the process of complex treatment: hormonotherapy+surgery. These indices have revealed correlation with pathogenetic variants of disease. Suppression has also been registered of T-lymphocytes under the influence of complex treatment. 35 patients received thymic factor "Thymalin" as a component of complex treatment. Its positive effects on cell immunity and some clinico-morphological parameters have been registered.
17 alpha-Hydroxyprogesterone Caproate↗
[Therapy of mastodynia and simple mastopathy].
Cycle-dependent breast complaints in most cases are based on a hormonal dysbalance with estrogen predominance and development of an interstitial edema. They preferably occur between 30-50 years of age with possibly appearing mastopathic tissue changes. Whereas the treatment with antiphlogistic, diuretic and other measures only effects symptomatically, a causal therapy effect can be achieved by systemic and local hormone applications. Within the bounds of a clinical study 92 women were submitted to a local treatment with a one per cent alcoholic progesterone ointment at least lasting a period of 3 months. In 52 Patient with primary ointment treatment an essential improvement of the complaints could be reached in 87% (p less than 0.05). In 40 women with secondary local hormonal application the improvement-rate was 70%. Side effects could be not established. The good therapeutic result and acceptance of this therapy form make clear that the permission of an alcoholic progesterone ointment as standard prescription would represent a therapeutic enrichment.
17 alpha-Hydroxyprogesterone Caproate↗