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Obesity and Baseline Estradiol Levels Are Independent Predictors for Initiation of Anastrozole in Hypogonadal Men on Clomiphene Citrate

PURPOSE: To assess the conversion rate from clomiphene citrate (CC) monotherapy to combination CC+anastrozole (AZ) therapy in hypogonadal men and the predictors associated with the initiation of AZ. MATERIALS AND METHODS: A retrospective review of records from hypogonadal men treated with CC in a si...

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Autores principales: Keihani, Sorena, Alder, Nathan J., Cheng, Philip J., Stoddard, Gregory J., Pastuszak, Alexander W., Hotaling, James M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society for Sexual Medicine and Andrology 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7502320/
https://www.ncbi.nlm.nih.gov/pubmed/32202084
http://dx.doi.org/10.5534/wjmh.190160
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author Keihani, Sorena
Alder, Nathan J.
Cheng, Philip J.
Stoddard, Gregory J.
Pastuszak, Alexander W.
Hotaling, James M.
author_facet Keihani, Sorena
Alder, Nathan J.
Cheng, Philip J.
Stoddard, Gregory J.
Pastuszak, Alexander W.
Hotaling, James M.
author_sort Keihani, Sorena
collection PubMed
description PURPOSE: To assess the conversion rate from clomiphene citrate (CC) monotherapy to combination CC+anastrozole (AZ) therapy in hypogonadal men and the predictors associated with the initiation of AZ. MATERIALS AND METHODS: A retrospective review of records from hypogonadal men treated with CC in a single fertility center was performed from 2013 to 2018. Patient age, body mass index (BMI), blood pressure, and reproductive hormones were obtained at baseline. Obesity was defined as BMI≥30 kg/m(2). Cox proportional hazards models were used to identify predictors of switching to combination CC+AZ therapy. RESULTS: A total of 318 men on CC were included. Median (interquartile range) age was 34 years (30–39 years) and patients were followed for a median of 9 months (4–17 months). Of these, 97 (30.5%) were started on CC+AZ therapy. These patients had higher baseline BMI and estradiol, which in multivariable regression were significant predictors for switching to CC+AZ therapy. A threshold of 18.5 pg/mL for baseline estradiol provided the highest accuracy for predicting the addition of AZ after adjusting for baseline BMI and total testosterone levels. CONCLUSIONS: In our practice, following CC monotherapy, 30% of men were initiated on CC+AZ. Obesity (BMI≥30 kg/m(2)) and baseline estradiol ≥18.5 pg/mL can predict the conversion to combination therapy with addition of AZ. This information can be used to counsel patients and also help to identify patients who can be started on combination therapy upfront.
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spelling pubmed-75023202020-10-01 Obesity and Baseline Estradiol Levels Are Independent Predictors for Initiation of Anastrozole in Hypogonadal Men on Clomiphene Citrate Keihani, Sorena Alder, Nathan J. Cheng, Philip J. Stoddard, Gregory J. Pastuszak, Alexander W. Hotaling, James M. World J Mens Health Original Article PURPOSE: To assess the conversion rate from clomiphene citrate (CC) monotherapy to combination CC+anastrozole (AZ) therapy in hypogonadal men and the predictors associated with the initiation of AZ. MATERIALS AND METHODS: A retrospective review of records from hypogonadal men treated with CC in a single fertility center was performed from 2013 to 2018. Patient age, body mass index (BMI), blood pressure, and reproductive hormones were obtained at baseline. Obesity was defined as BMI≥30 kg/m(2). Cox proportional hazards models were used to identify predictors of switching to combination CC+AZ therapy. RESULTS: A total of 318 men on CC were included. Median (interquartile range) age was 34 years (30–39 years) and patients were followed for a median of 9 months (4–17 months). Of these, 97 (30.5%) were started on CC+AZ therapy. These patients had higher baseline BMI and estradiol, which in multivariable regression were significant predictors for switching to CC+AZ therapy. A threshold of 18.5 pg/mL for baseline estradiol provided the highest accuracy for predicting the addition of AZ after adjusting for baseline BMI and total testosterone levels. CONCLUSIONS: In our practice, following CC monotherapy, 30% of men were initiated on CC+AZ. Obesity (BMI≥30 kg/m(2)) and baseline estradiol ≥18.5 pg/mL can predict the conversion to combination therapy with addition of AZ. This information can be used to counsel patients and also help to identify patients who can be started on combination therapy upfront. Korean Society for Sexual Medicine and Andrology 2020-10 2020-02-24 /pmc/articles/PMC7502320/ /pubmed/32202084 http://dx.doi.org/10.5534/wjmh.190160 Text en Copyright © 2020 Korean Society for Sexual Medicine and Andrology http://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Keihani, Sorena
Alder, Nathan J.
Cheng, Philip J.
Stoddard, Gregory J.
Pastuszak, Alexander W.
Hotaling, James M.
Obesity and Baseline Estradiol Levels Are Independent Predictors for Initiation of Anastrozole in Hypogonadal Men on Clomiphene Citrate
title Obesity and Baseline Estradiol Levels Are Independent Predictors for Initiation of Anastrozole in Hypogonadal Men on Clomiphene Citrate
title_full Obesity and Baseline Estradiol Levels Are Independent Predictors for Initiation of Anastrozole in Hypogonadal Men on Clomiphene Citrate
title_fullStr Obesity and Baseline Estradiol Levels Are Independent Predictors for Initiation of Anastrozole in Hypogonadal Men on Clomiphene Citrate
title_full_unstemmed Obesity and Baseline Estradiol Levels Are Independent Predictors for Initiation of Anastrozole in Hypogonadal Men on Clomiphene Citrate
title_short Obesity and Baseline Estradiol Levels Are Independent Predictors for Initiation of Anastrozole in Hypogonadal Men on Clomiphene Citrate
title_sort obesity and baseline estradiol levels are independent predictors for initiation of anastrozole in hypogonadal men on clomiphene citrate
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7502320/
https://www.ncbi.nlm.nih.gov/pubmed/32202084
http://dx.doi.org/10.5534/wjmh.190160
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