Subcutaneous Administration of a Depot Gonadotropin-Releasing Hormone Agonist Induces Profound Reproductive Axis Suppression in Women

Filicori, Marco; Cognigni, Graçiela Estela; Arnone, R.; Pocognoli, Patrizia; Tabarelli, C.; Ciampaglia, Walter; Taraborelli, Stefania; Casadio, Paolo

doi:10.1016/s0015-0282(97)00553-0

Cited by 16 publications

(14 citation statements)

References 8 publications

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“…However, because of its high expense, side effects and bone resorption, the patients' acceptability and compliance are much lower than expected. There is preliminary evidence that triptorelin depot injection can suppress the pituitary-gonadal axis for up to 8 weeks from the injection of the last dose [1,2] . A study demonstrates that, after a single dose of administration, leuprolin and triptorelin depots (3.75 mg) induce satisfactory ovarian suppression up to 6 and 7 weeks, respectively, with significantly reduced levels of endogenous LH [7] .…”

Section: Discussionmentioning

confidence: 99%

“…The resumption of menstruation took a mean of 77 days after the extended-interval dosing regimen, comparable to 82 days after the conventional regimen. A study from Italy reported a mean interval of 67-82 days after the last dose [2] . Therefore, the extended-interval dosing regimen may increase acceptability and patient compliance.…”

Section: Discussionmentioning

confidence: 99%

“…Administration of GnRH-a by depot every 4 weeks is a well-established regimen worldwide. However, it is reported [1][2] that after a single dose of triptorelin depot, the suppression of secretion of follicle-stimulating hormone (FSH) is maintained for 3-4 weeks afterwards. In addition, the level of luteinizing hormone (LH) starts to normalize in 8 weeks and the 17-␤ -oestradiol (E 2 ) level starts to normalize in weeks 7 and 8.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Gonadotropin-Releasing Hormone Agonist and an Extended-Interval Dosing Regimen in the Treatment of Patients with Adenomyosis and Endometriosis

Kang

Wang

Nie

et al. 2009

Gynecol Obstet Invest

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Aims: To determine the effects of gonadotropin-releasing hormone agonist (GnRH-a) and an extended-interval dosing regimen in the treatment of patients with adenomyosis and endometriosis. Methods: This was a prospective observational study in the setting of a hospital outpatient clinic. Seventy women suffering from adenomyosis and endometriosis were randomly divided into 2 groups: extended-interval dosing (experimental group) and conventional dosing (control group). Methods: Patients in the experimental group received a 4-dose regimen (triptorelin 3.75 mg by intramuscular injection every 6 weeks for a total of 4 doses). The patients in the control group received a conventional regimen (1 injection every 4 weeks for a total of 6 doses). The main outcome measures were relief and recurrence of dysmenorrhea and related climacteric symptoms, reduction of uterine volume, and serum levels of 17-β-oestradiol (E₂), luteinizing hormone (LH), and follicle-stimulating hormone (FSH). Results: The reliving rate of dysmenorrhea was 100% in patients treated with both the new regimen and the convention regimen after 6 months. The uterine volume was reduced 37.6% and 39.2%, respectively. And the levels of LH, FSH and E₂ were decreased significantly (p < 0.001). The E₂levels were reduced to the postmenopausal level. The hormone profile of the experimental group was similar to that of the control group (p > 0.05). Conclusion: The use of the extended-interval dosing regimen of triptorelin depot in patients with adenomyosis or endometriosis results in a consistent hypo-oestrogenised state, which is similar to that achieved by the conventional regimen. The new regimen reduces the cost of treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy of Gonadotropin-Releasing Hormone Agonist and an Extended-Interval Dosing Regimen in the Treatment of Patients with Adenomyosis and Endometriosis

Kang

Wang

Nie

et al. 2009

Gynecol Obstet Invest

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“…However, it is well known from clinical practice, that LHRH-agonist depot preparations induce cycle instability after an unsuccessful IVF cycle. This effect may be mainly due to persisting plasma concentrations after administration of an LHRH-agonist depot preparation like triptorelin [12]. In the 2 mg group most samples were below the limit of quantification, therefore these values could not be calculated and were assumed to be generelly below limit of quantification (blq) b Not in all patients probes from each day were available, therefore the sum from day to day is different Earlier studies have found no deleterious effect of LHRH antagonists on the luteal phase [9].…”

Section: Discussionmentioning

confidence: 99%

Plasma and follicular fluid concentrations of LHRH antagonist cetrorelix (Cetrotide®) in controlled ovarian stimulation for IVF

Ludwig¹,

Albano

Olivennes

et al. 2002

Arch Gynecol Obstet

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Cetrorelix was administered in differing daily dosages for controlled ovarian stimulation. The dosage levels were 3 mg (9 cycles), 1 mg (19 cycles), 0.5 mg (43 cycles), 0.25 mg (46 cycles) and 0.1 mg (7 cycles). In the 3 mg, 1 mg and 0.5 mg group the respective median plasma concentrations of cetrorelix on the day of oocyte pick-up (OPU) were 2.10 ng/ml, 1.42 ng/ml and 0.88 ng/ml and 1.03 ng/ml, 0.46 ng/ml and 0.49 ng/ml on the day of embryo transfer (ET). In the 0.25 mg and 0.1 mg groups plasma cetrorelix levels were below the limit of quantification. The cetrorelix concentrations in follicular fluid (FF) in the 0.25 mg group were detectable in only 14 out of 44 samples, while in the 0.1 mg group no detectable concentrations could be obtained. We also examined 80 cycles after single doses of 5 mg (7 cycles), 3 mg (42 cycles), and 2 mg (31 cycles) cetrorelix. On the day of OPU the respective median plasma concentrations of cetrorelix were 0.57 ng/ml, 0.62 ng/ml, and 0.56 ng/ml, and 0.61 ng/ml and 0.28 ng/ml on the day of ET in the 5 mg and 3 mg groups. In the 2 mg group, the plasma concentrations fell to below limits of quantification in 8/9 samples on the day of ET. In 26 out of 27 FF samples cetrorelix was detectable in the 3 mg single dose group (median level: 0.69 ng/ml).

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“…However, the cost and sharp pains on injection sites decline its adherence by both children and their family. It was reported [8] that prolonged administration intervals in adult women could exhibit similar effects. In this study, we explored the efficacies of subcutaneous administration of GnRH-a on girls with ICPP.…”

mentioning

confidence: 83%

Efficacy of subcutaneous administration of gonadotropin-releasing hormone agonist on idiopathic central precocious puberty

Wang

Zhang

Hou

et al. 2006

J. Huazhong Univ. Sc. Technol.

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In order to assess the feasibility of subcutaneous administration of Triptorelin with 6-week intervals for the suppression of pituitary-gonadal axis and changes of clinical signs in girls with idiopathic central precocious puberty (ICPP), 46 girls with ICPP were treated with GnRHa. Triptorelin (Decapeptyl, 3.75 mg) was administered subcutaneously (SC) at 6-weeks intervals or intramuscularly (IM) at 4-weeks intervals randomly for more than 12 months consecutively. During GnRHa therapy, clinical parameters and laboratory data, including height, weight, pubertal stage, bone age, uterine volume and ovarian size, serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH) and estradiol (E2), were monitored and analyzed. It was found that both treatment regimes led to regression of precocious puberty and reversal of secondary sexual characteristics. Breast developments regressed. Uterine volume was decreased after treatment, but there was no statistically significant difference. Mean ovarian volume did not change significantly during treatment. The height velocity was decreased significantly from 6.3+/-1.4 cm/year to 5.8+/-1.2 cm/year in group SC and 6.7+/-1.3 cm/year to 5.4+/-1.0 cm/year in group IM, respectively. The rate of bone maturation was reduced significantly during treatment. The ratio of deltaBA/deltaCA was 1.2+/-0.2 or 1.3+/-0.3 at the onset of therapy and decreased significantly after the treatment to 0.7+/-0.2 or 0.9+/-0.1, respectively. The predicted adult height was increased significantly and progressively during therapy. The levels of serum LH, FSH and E2 returned to the prepubertal condition. No significant side effects of therapy were noted. The most common side effect during SC treatment was that a non-irritating, 1 cm in diameter mass was palpated at the site of subcutaneous injection in the abdominal wall of patients, which disappeared after 6-12 weeks. Two girls had minimal withdrawal vaginal bleeding episodes after the first injection. It was concluded that both IM and SC triptorelin administrations were clinically effective. They induce profound suppression of hypothalamic-pituitary-gonadal axis while stabilizing height velocity, slowing bone maturation and increasing predicted adult height. These results suggest that subcutaneous injection of triptorelin in 6-weeks intervals at a dosage of 3.75 mg be a safe and acceptable regimen for ICPP

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Subcutaneous Administration of a Depot Gonadotropin-Releasing Hormone Agonist Induces Profound Reproductive Axis Suppression in Women

Cited by 16 publications

References 8 publications

Efficacy of Gonadotropin-Releasing Hormone Agonist and an Extended-Interval Dosing Regimen in the Treatment of Patients with Adenomyosis and Endometriosis

Efficacy of Gonadotropin-Releasing Hormone Agonist and an Extended-Interval Dosing Regimen in the Treatment of Patients with Adenomyosis and Endometriosis

Plasma and follicular fluid concentrations of LHRH antagonist cetrorelix (Cetrotide®) in controlled ovarian stimulation for IVF

Efficacy of subcutaneous administration of gonadotropin-releasing hormone agonist on idiopathic central precocious puberty

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