Cirrincione Lauren R, Huang Kai J, Sequeira Gina M
Department of Pharmacy, University of Washington, Seattle, WA, USA.
School of Medicine, University of California San Francisco, San Francisco, CA, USA.
Br J Clin Pharmacol. 2024 Oct;90(10):2387-2397. doi: 10.1111/bcp.16213. Epub 2024 Aug 26.
Adolescent transgender medicine is a growing clinical field. Gender-affirming medications for transgender youth may include gonadotropin-releasing hormone (GnRH) agonists, gender-affirming hormones or both. To evaluate the potential effects of GnRH agonists (puberty suppression) on pharmacokinetic processes for transgender youth, we searched PubMed from inception to May 2024 for publications on the effects of GnRH agonists on drug absorption, distribution, metabolism or excretion for transgender adolescents or effects on hormones (including gonadotropins, adrenal androgens, sex steroids) that are associated with changes in drug metabolism during puberty in the general adolescent population. No publications discussed the effects of GnRH agonist treatment on pharmacokinetic processes for adolescent transgender people. Sixteen publications observed marked decreases in gonadotropins and sex steroids for both adolescent transgender men and adolescent transgender women and slight effects on adrenal androgens. During GnRH agonist treatment, changes in body composition and body shape were greater for adolescent transgender people than for cisgender adolescent people. Further research is needed to better understand the effects of GnRH agonists on drug metabolism and other pharmacokinetic processes for transgender adolescents receiving GnRH agonists and other gender-affirming medications.
青少年跨性别医学是一个不断发展的临床领域。用于跨性别青少年的性别肯定药物可能包括促性腺激素释放激素（GnRH）激动剂、性别肯定激素或两者皆有。为了评估GnRH激动剂（青春期抑制）对跨性别青少年药代动力学过程的潜在影响，我们检索了从创刊到2024年5月的PubMed，以查找关于GnRH激动剂对跨性别青少年药物吸收、分布、代谢或排泄的影响的出版物，或对一般青少年人群青春期期间与药物代谢变化相关的激素（包括促性腺激素、肾上腺雄激素、性类固醇）的影响的出版物。没有出版物讨论GnRH激动剂治疗对青少年跨性别者药代动力学过程的影响。16篇出版物观察到，青少年跨性别男性和青少年跨性别女性的促性腺激素和性类固醇均显著下降，对肾上腺雄激素的影响较小。在GnRH激动剂治疗期间，青少年跨性别者的身体成分和体型变化比顺性别青少年更大。需要进一步研究，以更好地了解GnRH激动剂对接受GnRH激动剂和其他性别肯定药物的跨性别青少年的药物代谢和其他药代动力学过程的影响。
