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Efficacy and acceptability of injectable medroxyprogesterone. A comparison of 3-monthly and 6-monthly regimens.

Five hundred Black Rhodesian women given injections of 150 mg Depo-Provera every 3 months (group A) and 500 women given an injection of 450 mg Depo-Provera every 6 months (group B) were reviewed after 6 months. Group B had a significantly lower rate of defaulters. There was no significant difference between the groups with regard to weight gain, systolic and diastolic blood pressure increase, overall abnormal bleeding patterns and complaints of side-effects. Among those women who reported abnormal bleeding patterns, significantly more in group B had amenorrhoea. There was no significant increase of prolonged bleeding in group B. Among those women who complained of side-effects, significantly more in group B complained of headaches and a bloated abdomen. No pregnancies occurred in either group. The increased annual cost of the 450 mg injections, which was the main reason for women not accepting this regimen, is outweighed by convenience and reduced travel costs. Depo-Provera 450 mg given by 6-monthly injection is well tolerated and effective, and appears to be even more satisfactory as regards continued acceptance than 150 mg given every 3 months.

Adult↗

[Use of high doses of medroxyprogesterone acetate in the palliative treatment of advanced breast cancer. Clinical experience with 44 cases].

MAP was used in high doses (1 g/die up to a total dose of 45-50 g) in 44 cases of advanced mammary carcinoma (IIIrd and IVth stage of the T.N.M. classification), evaluated according to the criteria proposed by CBCG. The excellent tolerance to the drug, even at such high doses, is stressed. Therapeutic responses were best in cases of metastasis in the soft and bony tissues and in cases of pulmonary metastasis. It is pointed out that the effectiveness of the treatment is particularly evident in patients in whom the free interval has exceeded two years and in patients in the menopause for more than five years. In the light of results obtained, the possibility of introducing the drug into the therapeutic strategy of this condition is discussed.

Adult↗

[Double-blind method of the effect of menopause symptoms, lipid profile, and endometrial thickness of continuous therapy with estradiol valerate and medroxyprogesterone acetate].

Continuous combined therapy (CCT) using estrogens and progestagens has appeared as an alternative to avoid vaginal bleeding, which is characteristic of sequential hormone therapy, and the main reason for the stopping treatment. Irregular vaginal bleeding can occur at the beginning of treatment, but it has been observed that after a few months patients are in amenorrhea. Fifty postmenopausal women were studied in order to evaluate the clinical outcome. Half of them were treated with a product containing 2 mg estradiol valerate and 2.5 mg medroxiprogesterone acetate, while the other half received a placebo. Menopause symptomatology was recorded as described by Blatt-Kupperman, depression was evaluated with the use of Hamilton's test, lipid profile by enzymatic methods and endometrial thickness by transvaginal ultrasonography. Patients were evaluated at the beginning, third and sixth month of the study, following a double blind methodology. Symptomatology diminished both in patients under CCT and using placebo, although improvement was significantly greater in patient under CCT. Thus in the hormone treated group the Blatt-Kupperman score fell from 12.1 to 6.4 and 3.2 in the third and sixth month respectively, while in the group receiving placebo the score fell from 11.5 to 6.3 in the third month and raised to 7.4 in the sixth month. Hamilton's test showed a significant improvement of depression only in patients under hormone therapy. Nineteen out of twenty five women using CCT had vaginal bleeding, showing no changes in the endometrial thickness during the study. Finally, HDL-cholesterol was raised in 14.5% while LDL-cholesterol was lowered in 18.7% (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Double-Blind Method↗

[Treatment of recurrent uterine endometrial cancer in adjuvant therapy with medroxyprogesterone acetate (MPA) in addition of etoposide].

In recent years, we treated recurrent uterine endometrial cancer by combined therapy including CDDP. But in poor cases, like renal failure and such, it is difficult to perform the therapy. Two cases of recurrent uterine endometrial cancer treated earlier with MPA were presently treated with an addition of etoposide. The first case was given etoposide (50 mg/m2/day 4 times for 21 days by oral administration). The target tumor mass was reduced in size, occult blood vanished, and the tumor marker was reduced. The other case was treated with etoposide, 50 mg/body/day for 21 days by oral administration, but because of diarrhea, the dose had to be decreased to 25 mg/body/day every day. The tumor marker was reduced and genital bleeding vanished. These cases suggested that etoposide-MPA combined therapy might be effective for recurrent uterine endometrial cancer of well-differentiated type.

Adenocarcinoma↗