Testosterone kinetics on hypogonadal men under clomiphene.

Autor: Silva ÉD; UroScience, University of Campinas, Unicamp and Pontifical Catholic University of Campinas (PUC-Campinas), R. John Boyd Dunlop, s/n, Campinas, São Paulo, CEP 13060-904, Brazil., da Silva MM Jr; UroScience, University of Campinas, Unicamp and Pontifical Catholic University of Campinas (PUC-Campinas), R. John Boyd Dunlop, s/n, Campinas, São Paulo, CEP 13060-904, Brazil., Moretti TBC; UroScience, University of Campinas, Unicamp and Pontifical Catholic University of Campinas (PUC-Campinas), R. John Boyd Dunlop, s/n, Campinas, São Paulo, CEP 13060-904, Brazil., Andrade DL; UroScience, University of Campinas, Unicamp and Pontifical Catholic University of Campinas (PUC-Campinas), R. John Boyd Dunlop, s/n, Campinas, São Paulo, CEP 13060-904, Brazil., Avilez ND; UroScience, University of Campinas, Unicamp and Pontifical Catholic University of Campinas (PUC-Campinas), R. John Boyd Dunlop, s/n, Campinas, São Paulo, CEP 13060-904, Brazil., Reis LO; UroScience, University of Campinas, Unicamp and Pontifical Catholic University of Campinas (PUC-Campinas), R. John Boyd Dunlop, s/n, Campinas, São Paulo, CEP 13060-904, Brazil. reisleo.l@gmail.com.
Jazyk: angličtina
Zdroj: International urology and nephrology [Int Urol Nephrol] 2022 Aug; Vol. 54 (8), pp. 1807-1813. Date of Electronic Publication: 2022 May 16.
DOI: 10.1007/s11255-022-03230-4
Abstrakt: Objective: To evaluate total testosterone (TT) kinetics and its predictors 6 months after the discontinuation of clomiphene citrate (CC) in patients with hypogonadism.
Materials and Methods: Consecutive patients with normal testicles and male hypogonadism defined by TT < 300 ng/dl in the presence of signs or symptoms according to the previous consensus were prospectively evaluated in a urologic outpatient clinic by TT levels at baseline (T 0 ), after a daily dose of 50 mg CC for 40 days (T 1 ), and after the washout period of 6 months of CC discontinuation (T 2 ).
Results: Among 75 patients, mean age 56.8 years, testosterone at T 1  > 300 ng/dl was achieved by 69 (92%), 450-600 ng/dl by 32 (42.6%), and > 600 ng/dl by 27 (36.0%). 18 subjects (24%) maintained asymptomatic and TT levels over 300 ng/dl at T 2 . Age negatively related to testosterone response and T 1 response > 810 ng/dl predicts a median gain of 166.5 ng/dl at 6 months of CC discontinuation.
Conclusions: CC is a compelling option to treat male hypogonadism, although a chronic treatment is needed in most patients. About one in every four patients respond to a CC short trial to "reboot" the physiology. Further understanding of TT kinetics in these patients in the long term is warranted.
(© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
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