Medical study on aromatase inhibitors and growth

[Guest guest]

Hi everyone -

I have begun my research as we have to make a decision if we go

along with Dr. Harbison's recommendation to place on

Arimidex, which is an aromatase inhibitor. This medicine blocks the

production of estrogen, which then would, crossing our fingers, slow

down her rapid acceleration in bone age, thus allowing her more time

to grow in height.

As I wrote before, I had learned from Harbison and Stanhope in

London that this product is being studied right now by different

groups, and by the FDA, but is NOT FDA approved in the US at this

time. I know that the products are very commonly used at this time

in the fight against breast cancer. But these are adult women.

Clearly, the long-term side effects will not be known, and Steve and

I are going to have to take a leap of faith, if we decide to try

this drug. However, I did find a brand new article just published,

and a follow up.

First off, there are three types of aromatase inhibitors.

Letrozole, anastrozole (Arimidex) and Exemestane. Dr. H told me

that Letrozole is very very strong and she would not personally use

it in pediatric cases. However, I do have a study already in our

library using Letrozole in short boys in an attempt to postpone

adrenarche, slow bone age, and get greater height. The study was

positive. But I want to know about Arimidex.

A 12-month pilot trial was completed in US and just published in the

Journal of Pediatric Endocrin. Metabolism in Dec. 2004. They

investigated whether anastrozole (Arimidex) used for 12-months " can

achieve sustained suppression of estrogen production and delay

epiphyseal fusion in GHD adolescent males. " The study was only of

20 young GHD males but it did have a control group and a treatment

group. So although the numbers are small, it is critical that a

control group was used.

The study found that E2 (estrogen) concentrations declined 60% in

the treatment group but increased in the control group (I remember

Dr. H saying that Letrozole blocks estrogen completely, and Arimidex

partially blocked but that she felt that the partial was better than

complete).

Testosterone obviously increased in the treatment group, and

somewhat in the controls. Bone markers, plasma lipids, insulin,

glucose, and liver function tests were THANKFULLY all unchanged

between groups with no differneces either in bodh composition or

bone mineral density accrual.

However, in summary, it said that 12 months of treatment did not

increase predicted adult height. That further studies are needed to

look at longer treatment time.

Another study in 2002 refers to a " pioneering study " so I have to

find that. But refers to the recognition of the pivotal role of

estrogens in skeletal maturation and subsequent growth arrest. So

clearly we're on the right path. The question becomes personal for

us, do we try it and see if we can slow the bone age acceleration.

Salem

[Guest guest]

Hi ,

has been on Aromasin for about a year now (xxemestane). I often

wondered

what the difference was between this an Arimidex. After reading your post, I

did a little

online searching, and found a website that lists another type of aromatase

inhibitor:

Megace (megestrol). I was quite shocked to find this, because when , my

non-RSS

daughter was hospitalized earlier this year for severe reflux, she saw a

different GI doctor

than the one has seen his whole life. He seemed quite interested in

's

case, and asked me if I ever tried Megace when he was younger to stimulate

appetite. I

had never even heard of this, and has been on TONS of medications

throughout

the course of his lifetime. Now that I see it is listed as an aromatase

inhibitor used to treat

various conditions, I wonder if this could be a medicine that would kill 2 birds

with one

stone (so to speak) for our RSS kids. Is it possible it could work as an

aromatase inhibitor

to stop bone age advancement and as an appetite stimulant in lieu of Periactin?

I don't

have the energy to look into this further right now as our entire household has

a bad

stomach flu (6 people!). I thought you might be interested in this though.

Check these

websites:

http://imaginis.com/breasthealth/drugs.asp#aromatase

Look under classes of drugs to treat breast cancer. Then, click on Megace. It

says " in

addition to treating advanced breast cancer, Megace may also be used to treat

advanced

stages of endometrial cancer (cancer of the uterine lining) or to increase

appetite in HIV

patients. Because Megace is considered non-toxic, there are few documented side

effects

associated with the drug. The most common side effect is fluid retention.

Then, I looked at the following pdf. file:

journals.endocrinology.org/erc/006/0259/0060259.pdf

In it, it mentions this about Megace:

Vorozole has also been compared with megace in

tamoxifen-treated patients; complete and partial response

rates were seen in 10.5% of vorozole and 7.6% of patients

receiving megace but weight gain occurred in 14% of

patients receiving megace compared with only 1% of

those receiving vorozole (Goss et al. 1997).

Anastrozole was assessed in an early clinical study

(Plourde et al. 1994) and this showed considerable

suppression at doses between 1 and 20 mg. No other

endocrine changes were observed. A study reported by

Buzdar et al. (1997) compared anastrozole 1 mg,

anastrozole 10 mg and megace 160 mg in 386 tamoxifentreated

patients. No differences in response rate were seen.

However, side effects differed, with weight gain being

more prevalent in megace-treated patients and gastrointestinal

side effects in anastrozole-treated patients.

Here are the articles in which the Megace information came from:

Goss P, Wine E, Tannock I, Schwartz IH & Kremer AB for the

North American Vorozole Study Group 1997 Vorozole versus

Megace in postmenopausal patients with metastatic breast

carcinoma who had relapsed following tamoxifen.

Proceedings of American Society of Clinical Oncology No.

542.

Buzdar AU, SE, Vogel CL, Wolter J, Plourde P & Webster

A for the Arimidex Study Group 1997 A Phase III trial

comparing anastrozole (1 and 10 milligrams), a potent and

selective aromatase inhibitor, with megestrol acetate in

postmenopausal women with advanced breast carcinoma.

Cancer 79 730-739.

Dombernowsky P, I, Leonard R, Panasci L, Bellmunt J,

Bezwoda W, Gardin G, Gudgeon A, M, Fornasiero A,

Hoffman W, Michel J, Hatscheck T, Tjabbes T, Chaudri HA,

Hornberger U & Trunet PF 1998 Letrozole, a new oral

aromatase inhibitor for advanced breast cancer: double-blind

randomised trial showing a dose effect and improved efficacy

Endocrine-Related Cancer (1999) 6 259-263

263 and tolerability compared with megestrol acetate. Journal of

Clinical Oncology 16 453-461.

I'd be interested to hear what you think about this. Sorry this posting was so

long!

Kim C.

> Hi everyone -

>

> I have begun my research as we have to make a decision if we go

> along with Dr. Harbison's recommendation to place on

> Arimidex, which is an aromatase inhibitor. This medicine blocks the

> production of estrogen, which then would, crossing our fingers, slow

> down her rapid acceleration in bone age, thus allowing her more time

> to grow in height.

>

> As I wrote before, I had learned from Harbison and Stanhope in

> London that this product is being studied right now by different

> groups, and by the FDA, but is NOT FDA approved in the US at this

> time. I know that the products are very commonly used at this time

> in the fight against breast cancer. But these are adult women.

>

> Clearly, the long-term side effects will not be known, and Steve and

> I are going to have to take a leap of faith, if we decide to try

> this drug. However, I did find a brand new article just published,

> and a follow up.

>

> First off, there are three types of aromatase inhibitors.

> Letrozole, anastrozole (Arimidex) and Exemestane. Dr. H told me

> that Letrozole is very very strong and she would not personally use

> it in pediatric cases. However, I do have a study already in our

> library using Letrozole in short boys in an attempt to postpone

> adrenarche, slow bone age, and get greater height. The study was

> positive. But I want to know about Arimidex.

>

> A 12-month pilot trial was completed in US and just published in the

> Journal of Pediatric Endocrin. Metabolism in Dec. 2004. They

> investigated whether anastrozole (Arimidex) used for 12-months " can

> achieve sustained suppression of estrogen production and delay

> epiphyseal fusion in GHD adolescent males. " The study was only of

> 20 young GHD males but it did have a control group and a treatment

> group. So although the numbers are small, it is critical that a

> control group was used.

>

> The study found that E2 (estrogen) concentrations declined 60% in

> the treatment group but increased in the control group (I remember

> Dr. H saying that Letrozole blocks estrogen completely, and Arimidex

> partially blocked but that she felt that the partial was better than

> complete).

>

> Testosterone obviously increased in the treatment group, and

> somewhat in the controls. Bone markers, plasma lipids, insulin,

> glucose, and liver function tests were THANKFULLY all unchanged

> between groups with no differneces either in bodh composition or

> bone mineral density accrual.

>

> However, in summary, it said that 12 months of treatment did not

> increase predicted adult height. That further studies are needed to

> look at longer treatment time.

>

> Another study in 2002 refers to a " pioneering study " so I have to

> find that. But refers to the recognition of the pivotal role of

> estrogens in skeletal maturation and subsequent growth arrest. So

> clearly we're on the right path. The question becomes personal for

> us, do we try it and see if we can slow the bone age acceleration.

>

> Salem

[Guest guest]

Kim - I will investigate further, because my heart stopped when I

read in your email that Megace was an arimitase inhibitor. Both Dr.

Harbison and our geneticist out here both said NO WAY to Megace --

said something about the fluid retention and some other side effect

being very dangerous for RSS/SGA children -- and that Megace had not

yet been tested on pediatric cases of any kind. Now, that was about

3 years ago... maybe things have changed? I have not read of Megace

being used in any of the 4-5 pediatric growth disorder studies that

other arimitase inhibitors were discussed. I will find out some

more.

>

> Hi ,

>

> has been on Aromasin for about a year now (xxemestane). I

often wondered

> what the difference was between this an Arimidex. After reading

your post, I did a little

> online searching, and found a website that lists another type of

aromatase inhibitor:

> Megace (megestrol). I was quite shocked to find this, because

when , my non-RSS

> daughter was hospitalized earlier this year for severe reflux, she

saw a different GI doctor

> than the one has seen his whole life. He seemed quite

interested in 's

> case, and asked me if I ever tried Megace when he was younger to

stimulate appetite. I

> had never even heard of this, and has been on TONS of

medications throughout

> the course of his lifetime. Now that I see it is listed as an

aromatase inhibitor used to treat

> various conditions, I wonder if this could be a medicine that

would kill 2 birds with one

> stone (so to speak) for our RSS kids. Is it possible it could

work as an aromatase inhibitor

> to stop bone age advancement and as an appetite stimulant in lieu

of Periactin? I don't

> have the energy to look into this further right now as our entire

household has a bad

> stomach flu (6 people!). I thought you might be interested in

this though. Check these

> websites:

>

> http://imaginis.com/breasthealth/drugs.asp#aromatase

>

> Look under classes of drugs to treat breast cancer. Then, click

on Megace. It says " in

> addition to treating advanced breast cancer, Megace may also be

used to treat advanced

> stages of endometrial cancer (cancer of the uterine lining) or to

increase appetite in HIV

> patients. Because Megace is considered non-toxic, there are few

documented side effects

> associated with the drug. The most common side effect is fluid

retention.

>

> Then, I looked at the following pdf. file:

>

> journals.endocrinology.org/erc/006/0259/0060259.pdf

>

> In it, it mentions this about Megace:

>

> Vorozole has also been compared with megace in

> tamoxifen-treated patients; complete and partial response

> rates were seen in 10.5% of vorozole and 7.6% of patients

> receiving megace but weight gain occurred in 14% of

> patients receiving megace compared with only 1% of

> those receiving vorozole (Goss et al. 1997).

> Anastrozole was assessed in an early clinical study

> (Plourde et al. 1994) and this showed considerable

> suppression at doses between 1 and 20 mg. No other

> endocrine changes were observed. A study reported by

> Buzdar et al. (1997) compared anastrozole 1 mg,

> anastrozole 10 mg and megace 160 mg in 386 tamoxifentreated

> patients. No differences in response rate were seen.

> However, side effects differed, with weight gain being

> more prevalent in megace-treated patients and gastrointestinal

> side effects in anastrozole-treated patients.

>

> Here are the articles in which the Megace information came from:

>

> Goss P, Wine E, Tannock I, Schwartz IH & Kremer AB for the

> North American Vorozole Study Group 1997 Vorozole versus

> Megace in postmenopausal patients with metastatic breast

> carcinoma who had relapsed following tamoxifen.

> Proceedings of American Society of Clinical Oncology No.

> 542.

>

> Buzdar AU, SE, Vogel CL, Wolter J, Plourde P & Webster

> A for the Arimidex Study Group 1997 A Phase III trial

> comparing anastrozole (1 and 10 milligrams), a potent and

> selective aromatase inhibitor, with megestrol acetate in

> postmenopausal women with advanced breast carcinoma.

> Cancer 79 730-739.

>

> Dombernowsky P, I, Leonard R, Panasci L, Bellmunt J,

> Bezwoda W, Gardin G, Gudgeon A, M, Fornasiero A,

> Hoffman W, Michel J, Hatscheck T, Tjabbes T, Chaudri HA,

> Hornberger U & Trunet PF 1998 Letrozole, a new oral

> aromatase inhibitor for advanced breast cancer: double-blind

> randomised trial showing a dose effect and improved efficacy

> Endocrine-Related Cancer (1999) 6 259-263

> 263 and tolerability compared with megestrol acetate. Journal of

> Clinical Oncology 16 453-461.

>

> I'd be interested to hear what you think about this. Sorry this

posting was so long!

>

> Kim C.

>

>

>

> > Hi everyone -

> >

> > I have begun my research as we have to make a decision if we go

> > along with Dr. Harbison's recommendation to place on

> > Arimidex, which is an aromatase inhibitor. This medicine blocks

the

> > production of estrogen, which then would, crossing our fingers,

slow

> > down her rapid acceleration in bone age, thus allowing her more

time

> > to grow in height.

> >

> > As I wrote before, I had learned from Harbison and Stanhope in

> > London that this product is being studied right now by different

> > groups, and by the FDA, but is NOT FDA approved in the US at

this

> > time. I know that the products are very commonly used at this

time

> > in the fight against breast cancer. But these are adult women.

> >

> > Clearly, the long-term side effects will not be known, and Steve

and

> > I are going to have to take a leap of faith, if we decide to try

> > this drug. However, I did find a brand new article just

published,

> > and a follow up.

> >

> > First off, there are three types of aromatase inhibitors.

> > Letrozole, anastrozole (Arimidex) and Exemestane. Dr. H told me

> > that Letrozole is very very strong and she would not personally

use

> > it in pediatric cases. However, I do have a study already in

our

> > library using Letrozole in short boys in an attempt to postpone

> > adrenarche, slow bone age, and get greater height. The study

was

> > positive. But I want to know about Arimidex.

> >

> > A 12-month pilot trial was completed in US and just published in

the

> > Journal of Pediatric Endocrin. Metabolism in Dec. 2004. They

> > investigated whether anastrozole (Arimidex) used for 12-

months " can

> > achieve sustained suppression of estrogen production and delay

> > epiphyseal fusion in GHD adolescent males. " The study was only

of

> > 20 young GHD males but it did have a control group and a

treatment

> > group. So although the numbers are small, it is critical that a

> > control group was used.

> >

> > The study found that E2 (estrogen) concentrations declined 60%

in

> > the treatment group but increased in the control group (I

remember

> > Dr. H saying that Letrozole blocks estrogen completely, and

Arimidex

> > partially blocked but that she felt that the partial was better

than

> > complete).

> >

> > Testosterone obviously increased in the treatment group, and

> > somewhat in the controls. Bone markers, plasma lipids, insulin,

> > glucose, and liver function tests were THANKFULLY all unchanged

> > between groups with no differneces either in bodh composition or

> > bone mineral density accrual.

> >

> > However, in summary, it said that 12 months of treatment did not

> > increase predicted adult height. That further studies are

needed to

> > look at longer treatment time.

> >

> > Another study in 2002 refers to a " pioneering study " so I have

to

> > find that. But refers to the recognition of the pivotal role of

> > estrogens in skeletal maturation and subsequent growth arrest.

So

> > clearly we're on the right path. The question becomes personal

for

> > us, do we try it and see if we can slow the bone age

acceleration.

> >

> > Salem