Treatment of Androgen Excess in Adolescent Girls: Ethinylestradiol-Cyproteroneacetate Versus Low-Dose Pioglitazone-Flutamide-Metformin

Abstract

Low-dose PioFluMet compared favorably to EE-CA in adolescents with androgen excess and without pregnancy risk. The efficacy and safety of low-dose PioFluMet remain to be studied over a longer term and in larger cohorts.

Oral Contraception vs Insulin Sensitization for 18 Months in Nonobese Adolescents With Androgen Excess: Posttreatment Differences in C-Reactive Protein, Intima-Media Thickness, Visceral Adiposity, Insulin Sensitivity, and Menstrual Regularity

“…OGTTs were performed only at 0 and 24 months. Previous reports focused on 6-and 12-month results (6,7); the present report will focus on 18-and 24-month results.…”

“…Girls were recruited at the Adolescent Endocrinology Unit of Sant Joan University Hospital, Barcelona, Spain, in 2010 (6,7). The study population consisted of 34 adolescent girls with hyperinsulinemic androgen excess (mean age, 16 years; body mass index [BMI], 23 kg/m 2 , birth weight, 3.1 kg; and birth weight Z-score, Ϫ0.3), who were at least 2 years beyond menarche.…”

“…Inclusion criteria (6,7) were (1) hyperinsulinemia, defined as fasting insulin Ͼ15 U/mL and/or peak insulin Ͼ150 U/mL and/or mean insulin Ͼ84 U/mL on a 2-hour oral glucose tolerance test (OGTT), and (2) clinical and biochemical androgen excess, as defined by the presence of hirsutism (Ferriman-Gallwey score Ͼ8), amenorrhea or oligomenorrhea, and increased levels of circulating androstenedione and/or testosterone in the follicular phase of the cycle (days 3-7) or after 2 months of amenorrhea.…”

“…The randomization was web-based (www.SealedEnvelope.com) with random permuted blocks and strata for age and BMI (6,7 (6,7).…”

“…An alternative treatment for nonobese girls with androgen excess aims to normalize their endocrine-metabolic state and menstrual pattern with a low-dose, insulinsensitizing combination of metformin, flutamide, and pioglitazone (PioFluMet) (6,7).…”