Tamoxifen as a therapeutic agent in acromegaly

Irida Balili, Ariel Barkan

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objective: Administration of high doses of estrogens to patients with acromegaly has been shown to improve symptomatology of acromegaly and glucose tolerance more than 50 years ago. Selective estrogen receptor modulators (SERMs) mimic the effects of estrogen in bone, liver and the cardiovascular system, but function as an anti-estrogen in endometrial and breast tissue. In this study, we evaluated hormonal effects of a SERM, tamoxifen, in active acromegalic patients with particular emphasis on its use in males.

Design: We studied 15 men and 2 post-menopausal women with biochemically-active acromegaly despite the fact that other modalities were ineffective in normalizing their insulin-like growth factor-1 (IGF-1) levels. All patients were treated with tamoxifen 20–40 mg daily for 2–11 months (median of 4 months).

Methods: IGF-1 and growth hormone (GH) levels were assessed immediately before the beginning of treatment and at 2–4 monthly intervals thereafter. Baseline and treatment levels of total and bioavailable testosterone were measured in men.

Results: Tamoxifen did not affect basal GH secretion, but it decreased circulating IGF-I in 14 patients (82 %) by an average of 90 ± 4 mcg/L, (p = 0.005), and normalized plasma IGF-I in 8 patients (47 %). Total and bioavailable testosterone levels increased in all evaluable men (n = 8). Tamoxifen was well tolerated.

Conclusion: Tamoxifen might be useful in the treatment of patients with biochemically-mild active acromegaly, but longer term studies are warranted.

Original languageEnglish (US)
Pages (from-to)500-504
Number of pages5
JournalPituitary
Volume17
Issue number6
DOIs
StatePublished - Nov 7 2014
Externally publishedYes

Fingerprint

Acromegaly
Tamoxifen
Selective Estrogen Receptor Modulators
Estrogens
Somatomedins
Insulin-Like Growth Factor I
Growth Hormone
Testosterone
Therapeutics
Cardiovascular System
Breast
Bone and Bones
Glucose
Liver

Keywords

  • Estrogen
  • Growth hormone
  • IGF-1

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Medicine(all)

Cite this

Tamoxifen as a therapeutic agent in acromegaly. / Balili, Irida; Barkan, Ariel.

In: Pituitary, Vol. 17, No. 6, 07.11.2014, p. 500-504.

Research output: Contribution to journalArticle

Balili, Irida ; Barkan, Ariel. / Tamoxifen as a therapeutic agent in acromegaly. In: Pituitary. 2014 ; Vol. 17, No. 6. pp. 500-504.
@article{201f2bc754e34ecbade7c24c35d81a7c,
title = "Tamoxifen as a therapeutic agent in acromegaly",
abstract = "Objective: Administration of high doses of estrogens to patients with acromegaly has been shown to improve symptomatology of acromegaly and glucose tolerance more than 50 years ago. Selective estrogen receptor modulators (SERMs) mimic the effects of estrogen in bone, liver and the cardiovascular system, but function as an anti-estrogen in endometrial and breast tissue. In this study, we evaluated hormonal effects of a SERM, tamoxifen, in active acromegalic patients with particular emphasis on its use in males.Design: We studied 15 men and 2 post-menopausal women with biochemically-active acromegaly despite the fact that other modalities were ineffective in normalizing their insulin-like growth factor-1 (IGF-1) levels. All patients were treated with tamoxifen 20–40 mg daily for 2–11 months (median of 4 months).Methods: IGF-1 and growth hormone (GH) levels were assessed immediately before the beginning of treatment and at 2–4 monthly intervals thereafter. Baseline and treatment levels of total and bioavailable testosterone were measured in men.Results: Tamoxifen did not affect basal GH secretion, but it decreased circulating IGF-I in 14 patients (82 {\%}) by an average of 90 ± 4 mcg/L, (p = 0.005), and normalized plasma IGF-I in 8 patients (47 {\%}). Total and bioavailable testosterone levels increased in all evaluable men (n = 8). Tamoxifen was well tolerated.Conclusion: Tamoxifen might be useful in the treatment of patients with biochemically-mild active acromegaly, but longer term studies are warranted.",
keywords = "Estrogen, Growth hormone, IGF-1",
author = "Irida Balili and Ariel Barkan",
year = "2014",
month = "11",
day = "7",
doi = "10.1007/s11102-013-0534-9",
language = "English (US)",
volume = "17",
pages = "500--504",
journal = "Pituitary",
issn = "1386-341X",
publisher = "Kluwer Academic Publishers",
number = "6",

}

TY - JOUR

T1 - Tamoxifen as a therapeutic agent in acromegaly

AU - Balili, Irida

AU - Barkan, Ariel

PY - 2014/11/7

Y1 - 2014/11/7

N2 - Objective: Administration of high doses of estrogens to patients with acromegaly has been shown to improve symptomatology of acromegaly and glucose tolerance more than 50 years ago. Selective estrogen receptor modulators (SERMs) mimic the effects of estrogen in bone, liver and the cardiovascular system, but function as an anti-estrogen in endometrial and breast tissue. In this study, we evaluated hormonal effects of a SERM, tamoxifen, in active acromegalic patients with particular emphasis on its use in males.Design: We studied 15 men and 2 post-menopausal women with biochemically-active acromegaly despite the fact that other modalities were ineffective in normalizing their insulin-like growth factor-1 (IGF-1) levels. All patients were treated with tamoxifen 20–40 mg daily for 2–11 months (median of 4 months).Methods: IGF-1 and growth hormone (GH) levels were assessed immediately before the beginning of treatment and at 2–4 monthly intervals thereafter. Baseline and treatment levels of total and bioavailable testosterone were measured in men.Results: Tamoxifen did not affect basal GH secretion, but it decreased circulating IGF-I in 14 patients (82 %) by an average of 90 ± 4 mcg/L, (p = 0.005), and normalized plasma IGF-I in 8 patients (47 %). Total and bioavailable testosterone levels increased in all evaluable men (n = 8). Tamoxifen was well tolerated.Conclusion: Tamoxifen might be useful in the treatment of patients with biochemically-mild active acromegaly, but longer term studies are warranted.

AB - Objective: Administration of high doses of estrogens to patients with acromegaly has been shown to improve symptomatology of acromegaly and glucose tolerance more than 50 years ago. Selective estrogen receptor modulators (SERMs) mimic the effects of estrogen in bone, liver and the cardiovascular system, but function as an anti-estrogen in endometrial and breast tissue. In this study, we evaluated hormonal effects of a SERM, tamoxifen, in active acromegalic patients with particular emphasis on its use in males.Design: We studied 15 men and 2 post-menopausal women with biochemically-active acromegaly despite the fact that other modalities were ineffective in normalizing their insulin-like growth factor-1 (IGF-1) levels. All patients were treated with tamoxifen 20–40 mg daily for 2–11 months (median of 4 months).Methods: IGF-1 and growth hormone (GH) levels were assessed immediately before the beginning of treatment and at 2–4 monthly intervals thereafter. Baseline and treatment levels of total and bioavailable testosterone were measured in men.Results: Tamoxifen did not affect basal GH secretion, but it decreased circulating IGF-I in 14 patients (82 %) by an average of 90 ± 4 mcg/L, (p = 0.005), and normalized plasma IGF-I in 8 patients (47 %). Total and bioavailable testosterone levels increased in all evaluable men (n = 8). Tamoxifen was well tolerated.Conclusion: Tamoxifen might be useful in the treatment of patients with biochemically-mild active acromegaly, but longer term studies are warranted.

KW - Estrogen

KW - Growth hormone

KW - IGF-1

UR - http://www.scopus.com/inward/record.url?scp=84911997973&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84911997973&partnerID=8YFLogxK

U2 - 10.1007/s11102-013-0534-9

DO - 10.1007/s11102-013-0534-9

M3 - Article

VL - 17

SP - 500

EP - 504

JO - Pituitary

JF - Pituitary

SN - 1386-341X

IS - 6

ER -