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An open trial of long‐term testosterone suppression in spinal and bulbar muscular atrophy
Author(s) -
Yamamoto Tomotaka,
Yokota Kazuhiko,
Amao Rie,
Maeno Takashi,
Haga Nobuhiko,
Taguri Masataka,
Ohtsu Hiroshi,
Ichikawa Yaeko,
Goto Jun,
Tsuji Shoji
Publication year - 2013
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.23759
Subject(s) - leuprorelin , medicine , testosterone (patch) , atrophy , post hoc analysis , weakness , endocrinology , urology , physical medicine and rehabilitation , surgery , hormone , luteinizing hormone , gonadotropin releasing hormone
We investigated the long‐term effects of leuprorelin on leg‐muscle strength in spinal and bulbar muscular atrophy ( SBMA ). We hypothesized that testosterone suppression by leuprorelin would prevent the progression of muscle weakness. Methods In a prospective, long duration, open trial, 16 SBMA patients underwent medical castration with leuprorelin for 3.5 years. Chlormadinone was coadministered initially to prevent a testosterone surge. The strength of knee extension and flexion were quantitated using a torque machine. Results Our hypothesis was rejected. The leg strength measures decreased significantly with the mean reduction of 22.3–27.8%. In a post hoc analysis, the leg strength of 4 patients with higher pretreatment baseline total testosterone levels and short disease duration of 1–6 years were stronger at baseline and decreased by only 12.3–15.7% after treatment. Conclusions Leuprorelin was not effective in this small long‐term treatment trial in SBMA . The possibility that earlier treatment might be beneficial may deserve further study. Muscle Nerve 47: 816–822, 2013