SEARCH · Search PubMed

Results for “MEDROXYPROGESTERONE”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,063 records · Page 59Linked to original sources

PubMed1994

Bleeding patterns in postmenopausal women taking continuous combined or sequential regimens of conjugated estrogens with medroxyprogesterone acetate. Menopause Study Group.

OBJECTIVE: To compare the bleeding patterns obtained with two continuous combined and two sequential regimens of conjugated estrogens with medroxyprogesterone acetate (MPA) and conjugated estrogens alone. METHODS: This was a 1-year double-blind, randomized study done with 1724 postmenopausal women at 99 sites in the United States and Europe. All five treatment groups received 0.625 mg/day of conjugated estrogens. Groups A and B also took continuous daily doses of 2.5 and 5.0 mg of MPA, respectively. Groups C and D took 5.0 and 10.0 mg of MPA, respectively, for the last 14 days of each 28-day cycle. Group E took continuous daily doses of placebo to match MPA. RESULTS: The two continuous combined regimens (A and B) produced amenorrhea in 61.4 and 72.8%, respectively, of all evaluable cycles. Generally, the incidence of amenorrhea increased and irregular bleeding decreased with longer duration of treatment. In addition, amenorrhea occurred for at least the last seven consecutive cycles of the treatment year for about 40% of the patients taking the lower-dose continuous combined regimen (A), about 50% of the patients taking the higher-dose continuous combined regimen (B), and about 50% of the patients taking conjugated estrogens alone. About 5% of the patients who took either of the sequential regimens (C or D) had amenorrhea during that time. Most of the cycles (81.3 and 77.0% in groups C and D, respectively) for patients taking the sequential conjugated estrogens-MPA regimens had regular withdrawal bleeding or withdrawal spotting. There was no bleeding or spotting in 75.5% of the cycles for patients who took conjugated estrogens alone. CONCLUSIONS: Approximately half of the women who took the continuous combined conjugated estrogens-MPA regimens had amenorrhea, and the incidence tended to increase during the study. Women who took the sequential regimens had good cycle control with minimal irregular bleeding. More than half of those who took conjugated estrogens alone had amenorrhea.

Adult↗

PubMed1993

[Clinical pharmacokinetics and practical consequences of optimal use of medroxyprogesterone acetate].

Medroxyprogesterone acetate (MPA) is one of the major drugs used in endocrine therapy for advanced breast cancer. However, its optimal dose is still not clearly established. Response to treatment and drug-related side effects were analyzed as a function of plasma MPA concentrations during prolonged MPA administration. MPA plasma concentrations were measured (HPLC assay) at steady state (Css min) in 129 patients (mean age 63 years, 34-87) treated by MPA (111 being treated orally exclusively, with daily doses ranging from 400 to 2000 mg). A wide inter-patient variability was noted in MPA Css min for the 70 patients receiving 1000 mg/day per os: median 51 ng/ml, range 10-269 ng/ml. Intra-patient analysis of the evolution of MPA Css min during prolonged treatment showed relative stability of MPA concentrations (mean coefficient of variation = 21%). A weak but nevertheless significant correlation was demonstrated between oral doses and MPA Css min (P = 0.016). Thirty-five percent of patients (45/129) developed MPA-related side effects which were associated with the highest plasma MPA concentrations: medians were 81 and 32 ng/ml for toxic and non-toxic treatments respectively (P < 0.001). Moreover, the cumulative incidence of side-effects constantly increases with the elevation of Css min. Objective response was assessable in 55 patients treated by MPA exclusively. Plasma MPA concentrations were significantly different between patients with PD and those with either CR, PR or SD: medians were 46 and 65 ng/ml respectively (P = 0.025). The cumulative incidence of objective response increases up to 70 ng/ml. Analysis of toxicity and response as a function of the oral dose did not reveal any significant relationship. These data suggested an optimal therapeutic window for MPA Css min located within 50-70 ng/ml. This study demonstrates that, as opposed to the administered dose, plasma MPA concentration is a determining factor for toxicity and response to therapy.

Adult↗

PubMed1993

Effects of medroxyprogesterone acetate or gonadotrophin-releasing hormone agonist on suppression of spermatogenesis in the dog (Canis familiaris).

Medroxyprogesterone acetate (MPA) was administered as a depot injection to two adult male dogs. One was injected with 75 mg as a depot injection once a month for 2 months and the other with 50 mg at 2-weekly intervals for 1 month, followed by 100 mg at 2-weekly intervals for a further 2 months. Two other male beagles were given gonadotrophin-releasing hormone (GnRH) agonists (nafarelin derivative no. 49947 and nafarelin acetate) at a dose of 50 micrograms day-1 for either 22 or 23 days. The profiles of luteinizing hormone (LH) and testosterone were monitored before and during the treatment periods, and changes in the dogs' testes, epididymides and prostate glands were determined post mortem. In the MPA-treated animals, LH was suppressed for only very brief periods. In contrast, in the dogs treated with GnRH agonist, LH and testosterone concentrations were suppressed for most of the treatment period. In the MPA-treated animals, histological changes were seen mainly in the head of the epididymis, and in the acrosome region of the spermatozoa still present in this region of the male reproductive tract. The acrosome, instead of being closely applied to the sperm head, was in contact only in the most anterior areas, with the remainder forming a fan-like projection, indicating increasing detachment from the sperm head. In the dogs treated with GnRH agonist there was clear evidence of cessation of normal spermatogenesis in most of the seminiferous tubules. Changes in the histology of the head of the epididymis were similar to (but more profound than) those found in the dogs treated with MPA. Seminal changes were demonstrated in ejaculates collected during the latter stages of the treatment period.

Animals↗

PubMed1993

[Chemo-endocrine therapy with high dose medroxyprogesterone acetate for recurrent or advanced breast cancer].

The endocrine therapy with high-dose medroxyprogesterone acetate (MPA) was applied for 19 patients with recurrent breast cancer and 3 with advanced breast cancer. According to the dominant lesion of the disease, the patients were divided into three groups; 13 with soft tissue lesion, 5 with visceral lesion, and 4 with osseous lesion. The serum MPA level was higher than 25 ng/ml in 14 cases out of 19 examined. The results of objective responses in second-line therapy with MPA were CR in two cases, and NC or PD in 20 cases. In 19 out of 22 patients with MPA therapy, the periods of survival were longer than the period of 50% survival of the patients without MPA therapy.

Adult↗

PubMed1993

Comparison of two androgens plus depot-medroxyprogesterone acetate for suppression to azoospermia in indonesian men. World Health Organization. Task Force on Methods for the Regulation of Male Fertility.

OBJECTIVE: To compare the sperm suppression in Indonesian men achieved by combination treatment with either T enanthate or 19-nortestosterone ester) with depot-medroxyprogesterone acetate (depot-MPA). DESIGN: Prospective multicenter parallel group randomized trial. SETTING: Five centers in Faculties of Medicine in Indonesia. PARTICIPANTS: Ninety-six normal healthy volunteers. INTERVENTIONS: Seven weekly injections of T enanthate or 19-nortestosterone ester, 200 mg IM, followed by injections every 3 weeks to week 24. In both groups 250 mg depot-MPA was injected IM at 0, 6, 12, and 18 weeks. MAIN OUTCOME MEASURES: Sperm suppression by semen analysis at 3-week intervals and clinical chemistry, hematology, and gonadotrophin hormones monitored at 6-week intervals. Recovery assessed monthly until return to normal sperm concentration (> or = 20 x 10(6)/mL). RESULTS: Eighty-seven of 90 men (96.7%) achieved consistent azoospermia; 95.6% (43/45) and 97.8% (44/45) in the T and 19-nortestosterone groups, respectively. The remaining three men also suppressed to near azoospermic levels. Six of 96 men discontinued injections for failure to attend at the schedule time (3) and for medical reasons (3). Plasma FSH and LH concentrations were suppressed during treatment and returned to baseline levels during the recovery period. Clinical chemistry and hematologic values remained in the normal ranges throughout. More men complained of loss of libido in the 19-nortestosterone group (seven versus two, respectively). Median time to recover to normal sperm concentrations was 6.5 months. CONCLUSIONS: The two treatments were equally effective in sperm suppression. The rates of azoospermia achieved were higher than in previous studies with non-Indonesian men.

Adult↗

PubMed1994

[Advanced breast cancer with remarkable response to the combination therapy of mitoxantrone (MIT) and medroxyprogesteron acetate (MPA) after failure of anthracycline therapy: a case report].

A 67-year-old advanced breast cancer patient with multiple bone metastases showed a remarkable response to the combination therapy of mitoxantrone (MIT) and medroxyprogesteron acetate (MPA) after failure of anthracycline therapy. Eight course of CTF (cyclophosphamide, THP-adriamycin, 5-fluorouracil) and subsequent 4'-epi-adriamycin were performed for locally advanced breast cancer and multiple bone metastases, but the ulcerated breast cancer enlarged. Then the combination therapy of MIT (10 mg/day) and MPA (1,200 mg/day) was carried out. Seven months after treatment, the ulcerated breast cancer disappeared completely and the serum levels of CA 15-3, TPA and CEA decreased within the normal range. These results suggest that combination therapy with mitoxantrone may well be effective against the anthracycline-resistant breast cancer.

Aged↗

PubMed1993

Depot-medroxyprogesterone acetate (DMPA) and cancer: memorandum from a WHO meeting.

Depot-medroxyprogesterone acetate (DMPA) is a long-acting progestational contraceptive, which is administered by injection. It was developed in the mid-1960s, when it was seen as a method that would be particularly useful for women seeking reversible contraception who had difficulty taking a pill every day. DMPA has been shown to be a highly effective contraceptive, and it has proved acceptable in a variety of settings. The drug is licensed as a contraceptive in more than 90 countries and has been widely used in a number of them, such as Thailand and New Zealand. On a worldwide basis, the licensing, acceptability, and prevalence of use have been influenced by concern that DMPA may increase the risk of cancer. Cancer of the breast has been a particular concern. This Memorandum reviews comprehensively the results of toxicological tests in animals and epidemiological studies in humans concerning the carcinogenicity of DMPA.

Animals↗

PubMedDate not supplied

The effect of treatment with 4-hydroxyandrostenedione or medroxyprogesterone acetate on human breast tumour regression.

We have assessed cell deletion in breast tumours removed surgically from postmenopausal women by measuring the distribution ratio of acid phosphatase activity between the bound (in the lysosome) and free (in the phagosome) states. In benign breast tumours the acid phosphatase distribution ratio was much higher than that found in untreated malignant breast tumours. The acid phosphatase distribution ratio was also measured before and after treatment in malignant breast tumours removed from eight patients treated with 4-hydroxyandrostenedione (4-OH A) and in six patients treated with medroxyprogesterone acetate (MPA). Elevated acid phosphatase distribution ratios in benign compared with malignant tumours, and in malignant tumours after treatment from four of eight patients treated with 4-OH A and from three of six patients treated with MPA, may suggest higher cell deletion in these patients.

Acid Phosphatase↗

PubMed1977

Comparative contraceptive experience with three-month and six-month medroxyprogesterone acetate regimens.

Three-month (150 mg) and six-month (450 mg) contraceptive regimens of medroxyprogesterone acetate (DMPA) as an intramuscular depot injection are compared in this paper. A total of 19,875 women participated in the study, accounting for 220,530 woman-months of use. A Pearl index of 0.1069 for the three-month regimen was significantly lower than for the six-month group, where the index was 0.4943 (p less than 0.01). Side effects were limited insofar as personal reasons and loss to follow-up were the most important single category for discontinuation of this contraceptive method. No thrombotic incidents occurred. It is concluded that both contraceptive regimens of DMPA appear to be acceptable with regard to use-effectiveness, patient acceptance and prevalence of side effects.

Adolescent↗

PubMed1993

Cell cycle arrest of human hematopoietic progenitors induced by medroxyprogesterone acetate.

Clinical studies have shown that continuous or intermittent scheduled administration of medroxyprogesterone acetate (MPA) reduces the bone marrow toxicity induced by antitumor drugs. This MPA myeloprotection has been attributed to an arrest of hematopoietic progenitors in a quiescent phase, although no in vitro studies have demonstrated such an effect of MPA. Human bone marrow cells were preincubated for 3 days with MPA (100 ng/mL) and then exposed to sublethal doses of adriamycin; LD50 was significantly increased in MPA-preincubated cells (896 +/- 172 ng/mL) vs. control cells (162 +/- 37 ng/mL); this protective effect of MPA was shown to be more efficient against S-phase-specific drugs such as 5-fluorouracil (5-FU) than against non-phase-specific drugs such as cisplatin. MPA did not protect several human leukemic cell lines from the cytotoxic action of adriamycin. "Suicide" assays showed that the percentage of myeloid progenitor cells (granulocyte-macrophage colony-forming units [CFU-GM]) in S-phase was significantly reduced from 67 +/- 2.5% (control cells) to 38 +/- 5.5% (24-hour MPA-preincubated cells). These results demonstrate in vitro that MPA exerts a cell cycle arrest of hematopoietic precursors, protecting them from the toxicity of chemotherapy.

Antineoplastic Agents↗

PubMed1993

[Effect of medroxyprogesterone acetate on the anticellular activity of 5-fluorouracil against human breast and stomach cancer cells].

As 5-fluorouracil (5-FU) has been known to show clinically antitumor effects against both breast and stomach carcinomas. We compared the combined effects of medroxyprogesterone acetate (MPA) with 5-FU on the growth of cultured human breast and stomach carcinoma cells. MPA inhibited the growth of estrogen-dependent human breast carcinoma MCF-7 cells at the low concentrations and exhibited an additive effect in combination with 5-FU. MPA also inhibited the growth of human stomach carcinoma MKN-45 cells at relatively high concentrations and exhibited an additive effect in combination with 5-FU. Human stomach carcinoma MKN-28 cells were rather insensitive to MPA, but, an additive combination effect of MPA and 5-FU was observed. These three cell lines were found to have MPA-binding proteins which may be distinct from the nuclear progesterone receptor, suggesting the correlation with growth-inhibitory activity of MPA.

Breast Neoplasms↗

PubMed1993

[Effect of medroxyprogesterone acetate on antitumor efficacies and side effect of 5-fluorouracil].

Effect of medroxyprogesterone acetate (MPA) on the lethal toxicity, bone marrow toxicity and antitumor efficacies of 5-fluorouracil (5-FU) was examined. The following results were obtained. In aged female ddY mice, the lethal toxicity and body weight loss caused by 5-FU were reduced by MPA. MPA also reduced the bone marrow toxicity of 5-FU in aged female ddY mice. These effects of MPA were not observed in young male ddY mice. Moreover, MPA did not affect the antitumor activity of 5-FU against MPA-insensitive mouse breast carcinoma FM3A, or rather augmented its antitumor activity against MPA-sensitive human breast carcinoma MCF-7. These results indicate that MPA reduces the side effects of 5-FU and augments the antitumor activity of 5-FU in female mice.

Animals↗

PubMed1993

Low-dose oral medroxyprogesterone acetate in the management of the paraphilias.

BACKGROUND: There are no reports on the use of low-dose oral medroxyprogesterone acetate (MPA) in the treatment of the paraphilias. High-dose depot MPA treatment (500-800 mg i.m. weekly) has proven to control the behavioral manifestations of the paraphilias when testosterone levels decrease from pretreatment to prepubescent levels, but at the price of significant morbidity. METHOD: Oral MPA (60 mg/day for an average of 15.33 months) was given in an open nonblind trial to seven patients who met criteria for DSM-III-R paraphilias. Four of the subjects had shown inadequate improvement after 1 year of psychotherapy. RESULTS: Six subjects responded at 60 mg/day. Testosterone levels decreased by 50% to 75% (range, 100-400 ng/dL). No patient displayed significant side effects. All patients described significantly fewer paraphilic fantasies, and no patient reported engaging in paraphilic behaviors during oral MPA treatment. CONCLUSION: Double-blind placebo and phallometrically controlled tumescence studies need to be carried out to test the results of this study.

Administration, Oral↗

PubMedDate not supplied

Mitomycin C, methotrexate, and vincristine with medroxyprogesterone acetate or prednisolone for doxorubicin resistant advanced breast cancer--a randomized control study.

This randomized study was designed to compare the efficacy and toxicity of MMV chemotherapy (mitomycin C(MMC), methotrexate (MTX) and vincristine(VCR)), MMVM (MMV+medroxyprogesterone acetate(MPA)) and MMVP (MMV+prednisolone(P)), and to evaluate potential additional effects of MPA or P to the chemotherapy in doxorubicin (ADR)-refractory cancer patients. A total of 108 advanced breast cancer patients who had been resistant to ADR or who had relapsed after response were randomized to the three treatment arms: MMC 4mg/m2, MTX 35mg/m2 and VCR 0.7mg/m2, i.v., on days 1 and 8; repeated every 3 weeks. MPA 1,200 mg/day or P 10mg/day was given orally in the MMVM and MMVP arms, respectively. An interim analysis showed that the response to MMV was marginally significantly lower than the other groups; entry to the arm was thus interrupted. 102 patients were evaluable. Totally, response rates of 9.5%(2/21) in MMV, 37.5%(15/40) in MMVM and 29.2%(12/41) in MMVP were obtained. There was a significant difference in the response between the MMVM and MMV arms (p = 0.0206), and a marginal difference between MMVP and MMV (p = 0.0784). Although overall survivals in the 3 groups were equivalent, the time to progression of patients treated with MMVM and MMVP was shown to be significantly longer than MMV patients. Hematological adverse effects, especially thrombocytopenia, were significantly diminished by the addition of hormones, particularly MPA, to the chemotherapy, thus increasing total doses of chemotherapeutic agents. It was shown that in ADR-resistant cancers MMVM had an effect equivalent to that in ADR-sensitive breast cancers. The authors conclude that MMVM may be a candidate for a noncross resistant regimen for ADR-resistant cancers, as well as an effective 2nd line chemoendocrine treatment of advanced breast cancer.

Adult↗

PubMedDate not supplied

Phase II trial of mitoxantrone, doxifluridine and medroxyprogesterone acetate as second-line treatment for anthracycline-resistant metastatic breast cancer.

Sixteen patients with anthracycline resistant metastatic breast cancer were treated with a combination of mitoxantrone (MIT), doxifuridine (5'-DFUR) and medroxyprogesterone acetate (MPA). The median dose of anthracyclines was 360 mg (range 20-540 mg). Eligible patients received 7.0 mg/m2 of MIT every four weeks 600 mg of 5'DFUR were given orally every day. Eight (50.0%) out of 16 patients showed partial response. Six (54.5%) out of 11 bone lesions, 4 (80.0%) out of 5 lung lesions and 1 (20.0%) out of 5 soft tissue lesions responded to this treatment. The median response duration was 26 weeks (range 4-52). Hematological and gastrointestinal toxicity were tolerable. Alopecia was not observed. Tachycardia was noted in patients receiving more than 80 mg of MIT; however, digitalis controlled the symptom. The combined treatment with MIT is useful for anthracycline-resistant metastatic breast cancer.

Adult↗

PubMed1996

Influence of hormone replacement therapy (17 beta-OH estradiol and medroxyprogesterone acetate) on plasma concentration of prothrombin fragment F1+2 and thrombin-antithrombin III complex in postmenopausal woman.

The influence of hormone replacement therapy (HRT) on coagulation system has not been completely explained yet. We measured plasma levels of prothrombin fragment F1+2 and thrombin-antithrombin III complex before the treatment and after 6 and 12 months of HRT in 116 postmenopausal women HRT considered of transdermal estradiol and oral medroxyprogesterone acetate. We observed no statistically significant differences in plasma levels of the above coagulation markers before and during the treatment.

Adult↗

PubMedDate not supplied

Corticosteroids and medroxyprogesterone acetate inhibit the induction of E-selectin on the vascular endothelium by MDA-MB-231 breast cancer cells.

The vascular endothelium plays a critical role in cancer metastasis by directing circulating cancer cells into extravascular tissues and by expressing cell adhesion molecules. The authors investigated the interaction between breast cancer cells and vascular endothelial cells in the expression of E-selectin, and the effect of corticosteroids or medroxyprogesterone acetate (MPA) on such interaction. An MDA-MB-231 cell line, derived from human breast cancer induced E-selectin on the cell surface of human umbilical vascular endothelial cells. This induction was enhanced with a supplement of mononuclear cells of peripheral blood added to the culture medium. Corticosteroids and MPA blocked the induction of E-selectin proportional to concentration. Anti-IL-1 beta, but not anti-IL1 alpha or- TNF a, antibodies blocked induction. These findings suggest that MDA-MB-231 cells induce expression of E-selectin on vascular endothelium by releasing IL-1 beta directly or indirectly, but this induction is blocked by corticosteroids and MPA. Corticosteroids and MPA may inhibit cancer metastasis by blocking E-selectin expression on the vascular endothelium.

Antibodies, Monoclonal↗

PubMed1996

[Chemo-endocrine therapy including mitomycin C and medroxyprogesterone acetate in doxorubicin-refractory advanced breast cancer].

In the management of doxorubicin (ADR)-refractory advanced breast cancer, combination chemotherapies including mitomycin C (MMC) have been widely acknowledged to have definitive therapeutic effects. A randomized comparative study was performed estimating the efficacy and toxicity of MMV chemotherapy (MMC+methotrexate+vincristine), MMVM (MMV+medroxyprogesterone acetate (MPA), and MMVP (MMV+predo-nisolone (P). A total of 108 patients with advanced breast cancer resistant to ADR or relapsed after response were randomized, and 102 were evaluable. Response rates of 9.5% (2/21) in MMV, 37.5% (15/40) in MMVM, and 29.2% (12/41) in MMVP were obtained; with a significant difference between MMV and MMVM (p = 0.021). The time to progression of patients treated with MMVM and MMVP was shown to be longer than MMV patients. Thrombocytopenia was less appeared by adding MPA, making the dose escalation of MMV agents. It was concluded also from reviewing the references that MMVM is an effective 2nd-line therapy of advanced breast cancer after ADR treatment.

Aged↗