Seibert B, Günzel P
Institute for Experimental Toxicology, Schering AG, Berlin, Germany.
Contraception. 1994 Apr;49(4):303-33. doi: 10.1016/0010-7824(94)90030-2.
Results from toxicity studies performed for risk assessment of the combined injectable hormonal preparation Mesigyna are reviewed. Both components of Mesigyna, i.e., estradiol valerate (E2Val) and norethisterone enanthate (NET-EN), have been thoroughly investigated as individual compounds and some limited toxicity data have been obtained for the combination. Most findings which were gathered in these studies from different animal species occurred in the gonads, accessory genital and endocrine organs and can be related to the known species-specific pharmacological activity of a typical estrogen or progestin, respectively. No additional or unexpected information which might indicate a possible estrogen/progestin interaction was gained from the administration of the combined preparation to animals. Based on the results from toxicity testing, there were no objections to the long-term therapeutic use of Mesigyna for hormonal contraception. The predictive value of the effects (including the tumorigenicity) observed in the common laboratory animals with regard to human safety is critically discussed, taking the vast amount of previous experience with hormonal contraceptives into consideration. The conclusion is drawn that there is no animal model for safety assessment of sex steroids that adequately represents the human situation. Quantitative extrapolations from animal toxicity findings to humans, therefore, are not possible. Especially, the value of long-term studies and of toxicity studies on estrogen/progestin combinations is put into question. Like endocrine pharmacology studies, the toxicity studies with these steroid hormones are useful for the characterization of the possible endocrine pharmacological profile only.
对用于复方注射用激素制剂美施孕(Mesigyna)风险评估的毒性研究结果进行了综述。美施孕的两种成分,即戊酸雌二醇(E2Val)和庚酸炔诺酮(NET-EN),已作为单一化合物进行了全面研究,并且已获得了该复方制剂的一些有限毒性数据。这些研究从不同动物物种收集的大多数结果出现在性腺、附属生殖器官和内分泌器官中,并且分别与典型雌激素或孕激素已知的物种特异性药理活性相关。给动物施用复方制剂未获得可能表明雌激素/孕激素相互作用的额外或意外信息。基于毒性测试结果,对于美施孕用于激素避孕的长期治疗用途没有异议。考虑到以往大量使用激素避孕药的经验,对在常见实验动物中观察到的效应(包括致瘤性)对人类安全性的预测价值进行了批判性讨论。得出的结论是,没有一种能充分代表人类情况的用于性类固醇安全性评估的动物模型。因此,不可能从动物毒性研究结果进行定量外推至人类。特别是,长期研究以及雌激素/孕激素复方制剂的毒性研究的价值受到质疑。与内分泌药理学研究一样,这些甾体激素的毒性研究仅有助于表征可能的内分泌药理特征。