Department of Medicine, Division of Endocrinology, The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, California.
Department of Medicine, University of Washington, Seattle, Washington.
J Clin Endocrinol Metab. 2020 Mar 1;105(3):e835-47. doi: 10.1210/clinem/dgaa032.
11β-methyl-19-nortestosterone (11β-MNT) is a modified testosterone (T) with androgenic and progestational activity. A single oral dose of the prodrug, 11β-MNT dodecylcarbonate (11β-MNTDC), was well tolerated in healthy men.
We conducted a randomized, double-blind study at 2 academic medical centers. 42 healthy men (18-50 years) were randomized to receive oral placebo or 11β-MNTDC, 200 or 400 mg daily, for 28 consecutive days. Primary outcome (safety and tolerability) measures were assessed twice per week. Subjects underwent serial blood sampling over 24 hours on days 1 and 28 to assess secondary outcomes: pharmacokinetics (serum drug concentrations); pharmacodynamics of 11β-MNTDC (serum sex steroids and gonadotropins); and mood and sexual function (via validated questionnaires).
There were no serious adverse events. No participants discontinued because of an adverse event or laboratory test abnormality. 11β-MNTDC resulted in a dose-related increase in serum 11β-MNTDC and 11β-MNT concentrations sustained over 24 hours. Administration of 11β-MNTDC resulted in a marked suppression of serum gonadotropins, T, calculated free T, estradiol, and SHBG over the treatment period (P < 0.01). Adverse effects that may be related to 11β-MNTDC included weight gain, acne, headaches, fatigue, and mild mood changes, with 5 men reporting decreased libido and 3 decreased erectile/ejaculatory function. Serum low-density lipoprotein cholesterol, weight (~2 kg), hematocrit, and hemoglobin increased and serum high-density lipoprotein cholesterol decreased in both 11β-MNTDC groups.
Daily oral 11β-MNTDC for 28 days in healthy men markedly suppressed serum gonadotropin and T concentrations without serious adverse effects. These results warrant further evaluation of 11β-MNTDC as a potential male oral contraceptive.
11β-甲基-19-去甲睾酮(11β-MNT)是一种具有雄激素和孕激素活性的改良睾酮(T)。前药 11β-MNT 十二烷酸酯(11β-MNTDC)单次口服,在健康男性中具有良好的耐受性。
我们在 2 家学术医疗中心进行了一项随机、双盲研究。42 名健康男性(18-50 岁)随机接受口服安慰剂或 11β-MNTDC,每日 200 或 400mg,连续 28 天。每周两次评估主要结局(安全性和耐受性)指标。在第 1 天和第 28 天,对受试者进行了 24 小时连续血液采样,以评估次要结局:药代动力学(血清药物浓度);11β-MNTDC 的药效学(血清性激素和促性腺激素);以及情绪和性功能(通过验证问卷)。
无严重不良事件。没有参与者因不良事件或实验室检查异常而退出。11β-MNTDC 导致血清 11β-MNTDC 和 11β-MNT 浓度呈剂量相关性增加,持续 24 小时。11β-MNTDC 给药导致治疗期间血清促性腺激素、T、计算游离 T、雌二醇和 SHBG 显著抑制(P<0.01)。可能与 11β-MNTDC 相关的不良反应包括体重增加、痤疮、头痛、疲劳和轻度情绪变化,5 名男性报告性欲下降,3 名男性报告勃起/射精功能下降。在 11β-MNTDC 两组中,血清低密度脂蛋白胆固醇、体重(约 2kg)、红细胞压积和血红蛋白升高,血清高密度脂蛋白胆固醇降低。
健康男性每日口服 11β-MNTDC 28 天可显著抑制血清促性腺激素和 T 浓度,无严重不良事件。这些结果证明 11β-MNTDC 作为一种潜在的男性口服避孕药值得进一步研究。