Prospective randomized study comparing the long-acting gonadotropin-releasing hormone agonist triptorelin, flutamide, and cyproterone acetate, used in combination with an oral contraceptive, in the treatment of hirsutism
F. Pazos et al., Prospective randomized study comparing the long-acting gonadotropin-releasing hormone agonist triptorelin, flutamide, and cyproterone acetate, used in combination with an oral contraceptive, in the treatment of hirsutism, FERT STERIL, 71(1), 1999, pp. 122-128
Objective: To compare triptorelin, cyproterone acetate (CPA), and flutamide
, in combination with an oral contraceptive, in the treatment of hirsutism.
Design: Prospective randomized study. Setting(s): Tertiary care hospital.
Patient(s): Thirty-nine hirsute women with idiopathic or functional ovarian
hyperandrogenism.
Intervention(s): Patients were randomly assigned to receive triptorelin (3.
75 mg IM every 28 days), CPA (100 mg/d orally on days 1-10 of the menstrual
cycle), or flutamide (250 mg orally twice daily). All the patients also re
ceived a triphasic oral contraceptive.
Main Outcome Measure(s): Before and after 3 and 9 months of treatment, the
Ferriman-Gallwey score, hepatic function, and gonadal and adrenal steroid p
rofiles were evaluated.
Results: Thirty-three patients completed the 9-month study period. The Ferr
iman-Gallwey score decreased in all the groups. In the patients treated wit
h CPA or flutamide, a decrease in the hirsutism score was noted as soon as
after 3 months of treatment. This decrease was more pronounced after 9 mont
hs of treatment, especially in the patients who received flutamide, who had
lower hirsutism scores compared with the other treatment groups. None of t
he patients had abnormal liver function test results. There was a mild incr
ease in serum lipid concentrations, mostly in the group treated with tripto
relin.
Conclusion(s): Triptorelin, CPA, and flutamide are effective drugs for thr
treatment of hirsutism. Flutamide results in a greater reduction in the hir
sutism score, but CPA also offers satisfactory results at a much lower cost
. Triptorelin has no advantages over flutamide and CPA, and is the most exp
ensive of the three drugs tested. (C) 1998 by American Society for Reproduc
tive Medicine.