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Cyproteroneacetate and ACTH adrenal function.

J Girard, J B Baumann, U Bühler

    The Journal of Clinical Endocrinology and Metabolism
    |September 1, 1978
    PubMed
    Summary
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    Cyproterone acetate significantly suppresses ACTH, impacting adrenal function in rats and humans. Recovery of the ACTH adrenal system can take months after treatment cessation.

    Area of Science:

    • Endocrinology
    • Pharmacology

    Background:

    • Cyproterone acetate is an antiandrogenic and gonadotropin-inhibiting steroid.
    • It exhibits a notable suppressive effect on adrenocorticotropic hormone (ACTH).

    Purpose of the Study:

    • To investigate the ACTH suppressive effect of cyproterone acetate in animal models and human subjects.
    • To assess the impact on adrenal function and recovery time after treatment cessation.

    Main Methods:

    • Rats were treated with cyproterone acetate, and their ACTH and corticosterone responses to stress were evaluated.
    • Human volunteers and patients received single or multiple doses of cyproterone acetate, with assessments of ACTH, cortisol, and other steroid responses.
    • Adrenal function was assessed via various hormonal measurements and stress tests.

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    Main Results:

    • Cyproterone acetate induced adrenal atrophy and impaired ACTH and corticosterone responses in rats, with slow recovery.
    • In humans, a single dose impaired ACTH and 11-deoxycorticosteroid responses to metyrapone.
    • Impaired ACTH adrenal function was observed in children treated for precocious puberty, and ACTH levels were diminished in patients with elevated ACTH.

    Conclusions:

    • Cyproterone acetate exerts a pronounced ACTH-suppressive effect, varying with individual susceptibility and dose.
    • A cortisol-like effect is suggested, allowing patients to withstand stress.
    • Close monitoring of ACTH adrenal function and consideration of steroid cover during stress are crucial; withdrawal requires careful management due to prolonged recovery.