A comparison of androgens for anemia in patients on hemodialysis

N Engl J Med. 1981 Apr 9;304(15):871-5.

A comparison of androgens for anemia in patients on hemodialysis.

Neff MS, Goldberg J, Slifkin RF, Eiser AR, Calamia V, Kaplan M, Baez A, Gupta S,
Mattoo N.

To compare the erythropoietic effects of nandrolone decanoate, testosterone
enanthate, oxymetholone, and fluoxymesterone, we performed a randomized clinical
trial in patients with anemia who were receiving maintenance hemodialysis (the
women were not given testosterone enanthate). After a control period of at least
two months, patients received one of the drugs for six months and then returned
to control status; a second and third drug were administered in a similar
fashion. Seventy-seven patients completed the first drug period, 56 the second,
and 35 the third. The response to nandrolone and testosterone enanthate, the two
drugs given by injection, was clearly superior to the response to oxymetholone or
fluoxymesterone, given by mouth, in terms of the percentage of patients
responding and the mean rise in hematocrit. Approximately half the patients had
an increase of at least 5 percentage points in hematocrit after an injectable
androgen was given; more than half the women responded. Patients who required
transfusions regularly and those who had bilateral nephrectomies did not respond.

Peliosis: a morphologic curiosity becomes an iatrogenic problem.

Hum Pathol. 1978 May;9(3):331-40.

Peliosis: a morphologic curiosity becomes an iatrogenic problem.

Taxy JB.

Peliosis is a morphologic entity describing a condition of blood filled spaces,
most frequently occurring in the liver. In recent years it has evolved from an
anatomic curiosity seen at autopsy to a potential clinical problem in view of its
association with the administration of anabolic steroid hormones. The
pathogenesis and predilection of peliosis for the liver remain unexplained. This
article reports five patients with peliosis, four with splenic involvement, all
but one of whom received an anabolic steroid preparation. One patient died as a
result of rupture of the splenic peliotic spaces. The diagnosis in three cases
was established on the basis of surgical material, i.e., liver biopsy or
splenectomy. An increased awareness of peliosis in patients at risk, as well as
an appreciation for the histopathologic changes in less advanced cases, may
become an important issue for the surgical pathologist.

Peliosis hepatis. Twelve cases associated with oral androgen therapy.

Arch Pathol Lab Med. 1977 Aug;101(8):405-10.

Peliosis hepatis. Twelve cases associated with oral androgen therapy.

Nadell J, Kosek J.

Peliosis hepatis was encountered in 12 patients treated with high-dose
oxymetholone or fluoxymesterone therapy. In three cases liver failure was the
primary cause of death. In one case, the diagnosis was established by biopsy, the
androgen therapy was discontinued, and the lesion was absent at autopsy two years
later. In eight cases peliosis hepatis was an incidental finding at postmortem
examination. The clinical and anatomic features of these cases are described, and
previously reported cases of peliosis are briefly reviewed. A hypothesis is
offered to explain the association of this peculiar lesion with anabolic androgen
therapy.

Hereditary angioedema: modification of clinical manifestations with androgens.

Birth Defects Orig Artic Ser. 1976;12(6):283-7.

Hereditary angioedema: modification of clinical manifestations with androgens.

Davis PJ, Davis FB, Charache P.

HAE is an autosomal dominant trait of decreased levels or function of circulating
and tissue C'1 esterase inhibitor. The clinical illness is characterized by
disabling episodes of peripheral, oropharyngeal and gut-wall edema. Long-term
fluoxymesterone treatment of 5 affected males (393 patient-months) and
oxymetholone treatment of 6 affected females (204 patient-months) has
significantly decreased the frequency of attacks of edema without substantive
side effects.

Induction of premature menstruation with anabolic steroids.

Am J Obstet Gynecol. 1973 Sep 1;117(1):121-5.

Induction of premature menstruation with anabolic steroids.

Bolch OH Jr, Warren JC.

PIP: To determine the mechanism of the effect of certain anabolic steroids on
menstruation induction and to evaluate this effect as an interceptor of early
pregnancy, the luteal phase length was studied in the cycles of women ranging in
age from 21 to 37 years after postovulatory treatment with 7 different anabolic
steroids. Basal body temperature records were kept and endometrial biopsies were
obtained late in the pretreatment control periods to confirm ovulation. 2
steroids which had been proven to shorten the luteal cycle phase were
administered as follows: Nandrolone phenpropionate was given in a daily 50-mg
dose intramuscularly for 3 days. 30 mg of oxymetholone was administered orally
every 6 hours for 4 days. The previously untested steroids were administered
orally in evenly divided doses every 6 hours for 4 days as follows: oxandrolone,
60 mg daily; stanozolol, 28 mg; methandrostenolone, 60 mg; fluoxymesterone, 40
mg; and ethylestrenol, 30 mg. Plasma progesterone and gonadotropins were measured
by radioimmunoassay of blood samples taken 7 days after ovulation. Nandrolone and
oxymetholone were found to significantly shorten cycle and luteal phase lengths
and depress plasma LH and progesterone levels as compared to control cycles.
Nandrolone also significantly depressed plasma FSH levels. Of the 5 new drugs,
only ethylestrenol significantly shortened luteal phase length (p less than
.001). This finding is questioned by the small sample size and thus the use of
this steroid as a menstruation inducer is considered questionable. The mechanism
of the effect of nandrolone and oxymetholone appears to be due to their
antigonadotropic action that only secondarily reduces progesterone levels.
Whether these steroids can affect human chorionic gonadotropin and thus cripple
the corpus luteum and interrupt early pregnancy needs further research.

Androgen therapy in aplastic anaemia: a comparative study of high and low-doses and of 4 different androgens. French Cooperative Group for the Study of Aplastic and Refractory Anemias.

Scand J Haematol. 1986 Apr;36(4):346-52.

Androgen therapy in aplastic anaemia: a comparative study of high and low-doses and of 4 different androgens. French Cooperative Group for the Study of Aplastic and Refractory Anemias

[No authors listed]

ABSTRACT: A prospective randomized study of androgen therapy in aplastic anaemia (AA) was performed: 2 androgens (fluoxymesterone and norethandrolone) at high (1 mg/kg/d) and low (0.2 mg/kg/d) dose were studied on 110 patients; and 4 androgens given at high doses were objectively compared in 125 other cases. When patients are matched for AA severity there is an obvious efficiency of the high-dose androgens in the survival of the less severe cases of aplastic anaemia and in their haematological improvement. The data further show that, among the 4 androgens tested, fluoxymesterone is the most efficient and stanozolol the least. We conclude that androgen therapy is truly efficient in moderately severe aplastic anaemia and that fluoxymesterone (1 mg/kg/d) for 18 months should be chosen as reference drug to any new androgen therapy assay

Relative binding affinity of anabolic-androgenic steroids: comparison of the binding to the androgen receptors in skeletal muscle and in prostate, as well as to sex hormone-binding globulin.

Saartok T, Dahlberg E, Gustafsson JA.

Relative binding affinity of anabolic-androgenic steroids: comparison of the binding to the androgen receptors in skeletal muscle and in prostate, as well as to sex hormone-binding globulin.

Endocrinology. 1984 Jun;114(6):2100-6.

ABSTRACT: It is unclear whether anabolic steroids act on skeletal muscle via the androgen receptor (AR) in this tissue, or whether there is a separate anabolic receptor. When several anabolic steroids were tested as competitors for the binding of [3H]methyltrienolone (MT; 17 beta-hydroxy-17 alpha-methyl-4,9,11-estratrien-3-one) to the AR in rat and rabbit skeletal muscle and rat prostate, respectively, MT itself was the most efficient competitor. 1 alpha-Methyl-5 alpha-dihydrotestosterone (1 alpha-methyl-DHT; mesterolone) bound most avidly to sex hormone-binding globulin (SHBG) [relative binding affinity (RBA) about 4 times that of DHT]. Some anabolic-androgenic steroids bound strongly to the AR in skeletal muscle and prostate [ RBAs relative to that of MT: MT greater than 19-nortestosterone ( NorT ; nandrolone) greater than methenolone (17 beta-hydroxy-1-methyl-5 alpha-androst-1-en-3-one) greater than testosterone (T) greater than 1 alpha-methyl-DHT]. In other cases, AR binding was weak (RBA values less than 0.05): stanozolol (17 alpha-methyl-5 alpha- androstano [3,2-c]pyrazol-17 beta-ol), methanedienone (17 beta-hydroxy-17 alpha-methyl-1,4-androstadien-3-one), and fluoxymesterolone (9 alpha-fluoro-11 beta-hydroxy-17 alpha-methyl-T). Other compounds had RBAs too low to be determined (e.g. oxymetholone (17 beta-hydroxy-2-hydroxymethylene-17 alpha-methyl-5 alpha-androstan-3-one) and ethylestrenol (17 alpha-ethyl-4- estren -17 beta-ol). The competition pattern was similar in muscle and prostate, except for a higher RBA of DHT in the prostate. The low RBA of DHT in muscle was probably due to the previously reported rapid reduction of its 3-keto function to metabolites, which did not bind to the AR [5 alpha-androstane-3 alpha, 17 beta-diol and its 3 beta-isomer (3 alpha- and 3 beta-adiol, respectively)]. Some anabolic-androgenic steroids (only a few synthetic) bound to SHBG (1 alpha-methyl-DHT much greater than DHT greater than T greater than 3 beta-adiol greater than 3 alpha-adiol = 17 alpha-methyl-T greater than methenolone greater than methanedienone greater than stanozolol). The ratio of the RBA in rat muscle to that in the prostate (an estimate of the myotrophic potency of the compounds) was close to unity, varying only between about 0.4 and 1.7 in most cases.(ABSTRACT TRUNCATED AT 400 WORDS)