EFFECTS ON THE ENDOCRINE SYSTEM OF LONG-TERM TREATMENT WITH THE NONSTEROIDAL ANTIANDROGEN CASODEX IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA

Objective To study the hormonal changes resulting from long-term use o f the non-steroidal anti-androgen Casodex. Patients and methods A rand omized, placebo-controlled study was carried out on 27 patients with b enign prostatic hyperplasia (BPH). Fourteen patients received Casodex 50 mg daily for 24 weeks and 13 received a placebo. The patients were followed up for a further 24-week period. Results Serum concentrations of luteinizing hormone (LH) increased by an average of 40% while foll icle-stimulating hormone (FSH) remained unchanged, Testosterone increa sed by 35%, oestradiol by 29% and oestrone by 23%; all changes were st atistically significant. Levels of androstenedione and dihydrotestoste rone increased by 11% and 15%, respectively, but these increases did n ot reach statistical significance, A nonsignificant increase was also observed for ses hormone-binding globulin. The hormonal changes were r eversible upon discontinuation of therapy. Prolactin and dehydroepiand rosterone-sulphate levels did not change. Conclusion This study indica tes that Casodex, due to competitive inhibition of central androgen re ceptors, increases LH secretion, thus causing increased production and increased metabolism of testosterone.