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Journal
2019 | 9 | 4 | 88-91
Article title

„Iron Heart”: Reversible Cause of Dilated Cardiomyopathy Secondary to Cardiac Toxicity in Elderly Patient with Myelodysplastic Syndrome

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EN
Abstracts
EN
Triptorelin as the luteinizing hormone releasing hormone (LHRH) analogue has its own place among other available forms of androgen-depravation therapy (ADT) of locally advanced and metastatic prostate cancer (PCa). Nowadays, in times of development of new therapies in castration-resistant PCa, ADT remains the back bone therapy, which may be supplemented with one of novel drugs. The results of basic research indicate, that apart from the main mechanism of action based on lowering a testosterone concentration to the castration level, triptorelin may have a direct inhibitory effect on tumor cells. Formulations of tryptorelin are available to administer as 1-month, 3-months and 6-months sustained-release forms that may be given intramuscularly or subcutaneously. Constant concentration of triptoreline is maintained by using special microspheres in drug production. Pharmacokinetic and pharmacodynamic properties of particular forms were extensively tested, which allows for safe usage and retain of predictable and high efficacy. Indicators of effective ADT are fast reduction and maintenance of the state of castration. This phenomenon translates into a decrease of the prostate-specific antigen and longer survival. Triptorelin successfully meets these objectives based on a number of phase I–III studies. There is a noticeable lack of comparative studies on effectiveness of particular ADT forms. This may stem from an assumption, that all LHRH analogues demonstrate similar effectiveness because of the class effect. However, some evidence highlight significant differences in efficacy among these drugs. Triptorelin compares especially favourably, particularly as a drug reducing the testosterone level to the lower recommended values (< 20 ng/dl). Side effect profile during the therapy with triptorelin is largely the result of inhibition of the hypothalamic- pituitary-testicular axis. Hormonal disturbances linked to hipoandrogenism cause changes in lipid metabolism and glucose tolerance, which may influence the cardiovascular risk. This article is a review of key reports regarding triptorelin and a summary of the role that triptorelin plays in contemporary ADT in advanced PCa.
Discipline
Publisher

Journal
Year
Volume
9
Issue
4
Pages
88-91
Physical description
Contributors
  • Cardiology Department, University Hospital of Salamanca-IBSAL-CIBERCV
  • Hematology Department, University Hospital of Salamanca-IBSAL
  • Cardiology Department, University Hospital of Salamanca-IBSAL-CIBERCV
  • Cardiology Department, University Hospital of Salamanca-IBSAL-CIBERCV
  • Cardiology Department, University Hospital of Salamanca-IBSAL-CIBERCV
  • Hematology Department, University Hospital of Salamanca-IBSAL
  • Cardiology Department, University Hospital of Salamanca-IBSAL-CIBERCV
References
  • 1. Dayyani F, Conley AP, Strom SS et al. Cause of death in patients with lower-risk myelodysplastic syndrome. Cancer 2010; 116: 2174-9.
  • 2. Gujja P, Rosing DR, Tripodi DJ, Shizukuda Y. Iron overload cardiomyopathy: better understanding of an increasing disorder. J Am Coll Cardiol 2010; 56: 1001-12.
  • 3. Remacha AF, Arrizabalaga B, Villegas A et al. Evolution of iron overload in patients with low-risk myelodysplastic syndrome: iron chelation therapy and organ complications. Ann Hematol 2015; 94: 779-87.
  • 4. Modell B, Khan M, Darlison M et al. Improved survival of thalassaemia major in the UK and relation to T2* cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2008; 10: 42.
  • 5. Tanner MA, He T, Westwood MA et al. Multi-center validation of the transferability of the magnetic resonance T2* technique for the quantification of tissue iron. Haematologica 2006; 91: 1388-91.
  • 6. Wood JC. Impact of iron assessment by MRI. Hematology Am Soc Hematol Educ Program 2011; 2011: 443-50
Document Type
article
Publication order reference
Identifiers
YADDA identifier
bwmeta1.element.psjd-43b7852d-9f1a-4dc0-9ebe-e20a4d871252
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