Carmina Enrico, Lobo Rogerio A
Department of Endocrinology, University of Palermo, Palermo, Italy.
Clin Endocrinol (Oxf). 2002 Aug;57(2):231-4. doi: 10.1046/j.1365-2265.2002.01594.x.
To compare the relative effectiveness of two newer antiandrogens (flutamide and finasteride) with cyproterone acetate (CPA), at both low and high doses in the treatment of moderate to severe acne in hyperandrogenic women.
Forty-eight hyperandrogenic women were prospectively randomized to the following treatments for 1 year: CPA 2 mg with 35 micro g ethinylestradiol; CPA 50 mg with 25 micro g ethinylestradiol (reverse sequential regimen); flutamide 250 mg daily; and finasteride 5 mg daily. Assessment of Cook scores was the primary end-point of the trial. Blood for androgens was obtained at baseline in these women and 30 ovulatory age-matched controls.
Serum androgens were elevated in all 48 women and was similar in each of the four treatment groups. Cook scores were significantly and equally decreased (59-71%) with flutamide and both low and high doses of CPA (P < 0.01). The decrease with finasteride (-36 +/- 2%) was statistically significant but lower than that obtained with the other agents. All treatments were well tolerated.
In hyperandrogenic women with moderate to severe acne, low doses of certain antiandrogens appear to be effective. Low and high doses of CPA with ethinylestradiol were equally effective and were comparable to the effects of a low dose of flutamide. Finasteride was less beneficial.
比较两种新型抗雄激素药物（氟他胺和非那雄胺）与醋酸环丙孕酮（CPA）在低剂量和高剂量时治疗高雄激素性女性中度至重度痤疮的相对疗效。
48名高雄激素性女性被前瞻性随机分为以下治疗组，为期1年：2毫克CPA与35微克炔雌醇；50毫克CPA与25微克炔雌醇（反向序贯疗法）；每日250毫克氟他胺；以及每日5毫克非那雄胺。评估Cook评分是该试验的主要终点。在这些女性的基线期以及30名年龄匹配的有排卵对照者中采集血液检测雄激素。
所有48名女性的血清雄激素均升高，且四个治疗组中的每一组情况相似。氟他胺以及低剂量和高剂量的CPA均使Cook评分显著且同等程度降低（59 - 71%）（P < 0.01）。非那雄胺使Cook评分降低（-36 ± 2%），差异有统计学意义，但低于其他药物。所有治疗耐受性良好。
在患有中度至重度痤疮的高雄激素性女性中，某些低剂量抗雄激素药物似乎有效。低剂量和高剂量的CPA与炔雌醇疗效相当，且与低剂量氟他胺的效果相当。非那雄胺的益处较小。
