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Endocrine Abstracts (2019) 63 P1113 | DOI: 10.1530/endoabs.63.P1113

ECE2019 Poster Presentations Pituitary and Neuroendocrinology 3 (73 abstracts)

The impact of clomiphene citrate as add-on therapy in male acromegalic patients non-responsive to combined medical therapy

Lucio Vilar 1, , Clarice Vilar 2, , Luciano Albuquerque 1 , Erik Trovão 1 , Ana Carolina Thé 1 , Patricia Gadelha 1 , Renata Campos 1 , Izabela Cardoso 1 , Thaíse Borges 1 & Ruy Lyra 1


1Division of Endocrinology, Hospital das Clinicas, Pernambuco Federal University, Recife, Brazil; 2Pernambuco Endocrine Research Center, Recife, Brazil; 3Olinda Medical School (FMO), Olinda, Brazil.


Introduction: Clomiphene citrate (CC), a selective estrogen receptor modulator that increases LH and FSH secretion, improves hypogonadism and fertility outcomes. Moreover, there is limited evidence that it may also be helpful as add-on therapy to normalize IGF-1 levels in male acromegalic patients.

Objective: To assess the effect impact of CC on serum IGF-1 and testosterone levels in male acromegalic patients not controlled by the combination of lanreotide autogel (a first generation somatostatin analogue) and cabergoline (a dopamine agonist).

Study Design: In this prospective, open-label, single-center trial, CC (50 mg/day) was added to previous medical treatment (combination of lanreotide autogel and cabergoline) for 3 months. Hormonal assessment (GH, IGF-1 and testosterone levels) was performed before and 3 months after CC introduction.

Patients: Eight male patients (mean age, 40.75 ± 9.32 years; median age, 42 years; range, 26–54 years) met the following criteria: IGF-1 above the upper limit of normal (ULN) range for at least 1 year despite the use of combined medical therapy.

Results: Three months after CC introduction, serum IGF-1 levels decreased in all patients and reached normal values in 2 patients (25%). Noteworthy, IGF-1 normalization occurred in two of the three patients (66.7%) with baseline IGF-1 levels of up to 2 times the ULN. There was no significant change in GH levels. Conversely, total serum testosterone levels increased in all patients, reaching normal levels in 50% (three of six) of those considered to be hypogonadal (total testosterone < 300 ng/dL). Overall, CC was well tolerated and no patient needed to interrupt the treatment.

Conclusion: Addition of the low cost CC may be hepful to normalize IGF-1 levels in male acromegalic patients not controlled by the combination of SAs and cabergoline, particularly those with mild IGF-1 elevation (up to two times the ULN). Moreover, improvement of testosterone levels can be obtained in patients with concurrent central hypogonadism.

Volume 63

21st European Congress of Endocrinology

Lyon, France
18 May 2019 - 21 May 2019

European Society of Endocrinology 

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