Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2012) 29 P917

ICEECE2012 Poster Presentations Female Reproduction (99 abstracts)

Treatment of androgen excess in adolescent girls: ethinylestradiol–cyproteroneacetate vs low-dose pioglitazone–flutamide–metformin

L. Ibañez 1 , M. Díaz 1 , M. Rodriguez-Chacón 2 , E. Maymo-Masip 2 , C. Salvador 3 , A. López-Bermejo 4 , J. Vendrell 2 & F. de Zegher 5


1Sant Joan de Déu, University of Barcelona & CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Esplugues, Barcelona, Spain; 2CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III & University Hospital of Tarragona Joan XXIII, Pere Virgili Institute, Tarragona, Spain; 3Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain; 4Girona Institute for Biomedical Research, Hospital de Girona Dr Josep Trueta, Girona, Spain; 5University of Leuven, Leuven, Belgium.


Objective: To compare the effects of a classic therapy to those of a novel treatment for androgen excess in adolescent girls.

Study design: Randomized, open-labeled trial over 12 months.

Study participants: Adolescents (n=34; mean age 16 year, BMI 23 kg/m2) with hyperinsulinemic androgen excess and without risk of pregnancy.

Interventions: Ethinyl estradiol-cyproterone acetate (EE-CA; Diane 35 Diario) vs a low-dose combination of pioglitazone 7.5 mg/day, flutamide 62.5 mg/day, and metformin 850 mg/day (PioFluMet) for 12 months.

Main outcome measures: Hirsutism and acne scores; androgen excess; circulating C-reactive protein and high-molecular-weight adiponectin; carotid intima-media thickness; body composition (by absorptiometry); abdominal fat partitioning (by MRI); gene expression in consecutive biopsies of subcutaneous adipose tissue at the abdominal level.

Results: EE-CA and PioFluMet reduced the clinical and biochemical androgen excess comparably but had divergent effects on C-reactive protein and high-molecular-weight adiponectin; on carotid intima-media thickness; on lean mass; on abdominal and visceral fat; and on the expression of genes, for example, those related to macrophage activation and lipid storage in adipose tissue. All these divergences pointed to a healthier condition on low-dose PioFluMet.

Conclusion: Over 12 months, PioFluMet compared favorably to EE-CA in adolescents with androgen excess and without pregnancy risk. Further study of low-dose PioFluMet seems warranted, not only to strengthen its safety side over the longer term and in larger cohorts, but also to verify further whether the efficacy of this low-dose combination holds enough potential to allow it to become a first-choice therapy for the majority of young adolescents with androgen excess, namely those who are not at pregnancy risk and who are nowadays nevertheless exposed to supraphysiological doses of estro-progestagens.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Volume 29

15th International & 14th European Congress of Endocrinology

European Society of Endocrinology 

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