The pharmacokinetics of medroxyprogesterone acetate following two different loading dose schedules in advanced carcinoma of the breast

Canney, P; Dowsett, Mitch; Priestman, T. J.

doi:10.1038/bjc.1988.165

Cited by 6 publications

(2 citation statements)

References 8 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Peak serum levels for DMPA-SC have been reported in the range 1.6 to 4.4 nM ( 62 , 63 ), which appears to be lower than for DMPA-IM, but plateau concentrations (C30, see Table 1 ) and contraceptive efficacy appear to be similar ( 62 , 61 ). MPA used therapeutically to treat breast and endometrial cancers by ingestion or intramuscular injection of ∼1000 mg daily results in serum concentrations of 26 to 2030 nM for oral administration ( 78 ) or 251 to 422 nM by intramuscular injection ( 79 ), resulting in endocrine disruption and immunosuppression ( 35 , 80 , 81 ). Lower oral doses of MPA result in serum concentrations of ∼15 to 120 nM for 100 mg ( 82 ) and ∼100 to 420 nM for 200 mg ( 83 ).…”

Section: Contraceptives: Actions Types and Serum Concentrationsmentioning

confidence: 99%

Hormonal Contraception and HIV-1 Acquisition: Biological Mechanisms

2018

View full text Add to dashboard Cite

Access to effective affordable contraception is critical for individual and public health. A wide range of hormonal contraceptives (HCs), which differ in composition, concentration of the progestin component, frequency of dosage, and method of administration, is currently available globally. However, the options are rather limited in settings with restricted economic resources that frequently overlap with areas of high HIV-1 prevalence. The predominant contraceptive used in sub-Saharan Africa is the progestin-only three-monthly injectable depot medroxyprogesterone acetate. Determination of whether HCs affect HIV-1 acquisition has been hampered by behavioral differences potentially confounding clinical observational data. Meta-analysis of these studies shows a significant association between depot medroxyprogesterone acetate use and increased risk of HIV-1 acquisition, raising important concerns. No association was found for combined oral contraceptives containing levonorgestrel, nor for the two-monthly injectable contraceptive norethisterone enanthate, although data for norethisterone enanthate are limited. Susceptibility to HIV-1 and other sexually transmitted infections may, however, be dependent on the type of progestin present in the formulation. Several underlying biological mechanisms that may mediate the effect of HCs on HIV-1 and other sexually transmitted infection acquisition have been identified in clinical, animal, and ex vivo studies. A substantial gap exists in the translation of basic research into clinical practice and public health policy. To bridge this gap, we review the current knowledge of underlying mechanisms and biological effects of commonly used progestins. The review sheds light on issues critical for an informed choice of progestins for the identification of safe, effective, acceptable, and affordable contraceptive methods.

show abstract

Section: Contraceptives: Actions Types and Serum Concentrationsmentioning

confidence: 99%

Hormonal Contraception and HIV-1 Acquisition: Biological Mechanisms

2018

View full text Add to dashboard Cite

show abstract

“…route was thought to prolong the exposure time of tumour cells (Blossey et al, 1984;Canney et al, 1988;Etienne et al, 1992). In an adjuvant situation, HD-MPA intramuscularly given during 6 months would in fact accomplish exposure to the drug for at least 3 months more (Blossey et al, 1984;Canney et al, 1988;Etienne et al, 1999). Regarding the chosen dose, it was shown in advanced disease that no further tumour regression could be obtained from daily MPA IM doses over 500 mg during the loading phase (Robustelli Della Cuna et al, 1980;Tamassia et al, 1982).…”

Section: Discussionmentioning

confidence: 99%

Adjuvant high-dose medroxyprogesterone acetate for early breast cancer: 13 years update in a multicentre randomized trial

et al. 2001

View full text Add to dashboard Cite

SummaryThe authors updated their report on a randomized trial initiated in 1982 comparing, in early breast cancer, high-dose IM Medroxyprogesterone acetate (HD-MPA) adjuvant hormonotherapy during 6 months with no hormonotherapy; node-positive patients also received 6 courses of IV CMF (day 1, day 8; q.4 weeks). 246 node-negative (NN) and 270 node-positive (NP) patients had been followed for a median duration of 13 years. Previous results were confirmed in this analysis on mature data. In NN patients, relapse-free survival (RFS) was improved in the adjuvant hormonotherapy arm, regardless of age while overall survival (OAS) was also increased in younger (less then 50 years) patients. In the whole group of NP patients, no difference was seen regarding RFS or OAS. However, an age-dependant opposite effect was observed: younger patients (< 50) experienced a worse and significant outcome of relapse-free and overall survivals when receiving adjuvant HD-MPA while older patients (> = 50) enjoyed a significant improvement of their relapse-free survival. For both NN and NP patients, differences in overall survivals observed in older women with a shorter follow-up, were no longer detected.

show abstract