Clinical use of aromatase inhibitors (AI) in premenopausal women

Details

Serval ID
serval:BIB_F2C92985756A
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Title
Clinical use of aromatase inhibitors (AI) in premenopausal women
Journal
Journal of Steroid Biochemistry and Molecular Biology
Author(s)
de Ziegler  D., Mattenberger  C., Luyet  C., Romoscanu  I., Irion  N. F., Bianchi-Demicheli  F.
ISSN
0960-0760
Publication state
Published
Issued date
05/2005
Peer-reviewed
Oui
Volume
95
Number
1-5
Pages
121-7
Notes
Journal Article
Review --- Old month value: May
Abstract
Aromatase inhibitors (AI) block the last enzymatic step of estrogen production, the aromatization of the A-cycle of aromatizable androgens and particularly, androstenedione (delta4) and testosterone (T). Molecules designed for interfering with aromatase activity have existed for many years. Yet the activity of products of the aminogluthetimide era was unspecific and these substances carried too many side effects for being used clinically. Newer third generation AIs, however, are highly specific and essentially devoid of side effects. These molecules have recently been approved for treating breast cancer in postmenopausal women either, in advanced forms or, as part of adjuvant therapy. In women whose ovaries are active, a temporary inhibition of E2 production will raise gonadotropins and in turn, stimulate follicular growth. In cancer patients, this property precludes the use of AIs in women whose ovaries are still active, unless gonadotropins are blocked. But in infertility patients, this property of AIs has been put to play for inducing ovulation. AIs have been used both in women who do not ovulate but whose hypothalamo-pituitary-gonadal (HPG) axis is active (oligo-anovulators of PCOD type) and those who ovulate regularly but in whom multiple ovulation is sought for treating unexplained infertility or as part of IVF. Like clomiphene citrate (CC), AIs are not usable in women whose gonadotropins are suppressed, as in the case of hypothalamic amenorrhea. The sum of data available on the use of AI for inducing ovulation remains however meager to this date and is mainly constituted of pilot and non-randomized trials. Yet mounting evidence tends to support AIs' advantages over CC for induction of ovulation. Hence, we think that the likelihood that these drugs will play a key role in induction of ovulation in the future is high. AIs appear particularly interesting for treating unexplained infertility because AI-FSH/hMG regimens are lighter than FSH-only regimens while retaining the high pregnancy rates of these latter treatments.
Keywords
Aromatase Inhibitors/pharmacology/*therapeutic use/toxicity Clomiphene/pharmacology Dinoprostone/pharmacology Embryo, Mammalian/drug effects Female Humans Infertility, Female/*drug therapy Luteinizing Hormone/pharmacology Ovulation/*drug effects *Premenopause
Pubmed
Web of science
Create date
28/02/2008 12:36
Last modification date
20/08/2019 17:19
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