Medroxyprogesterone Decreases Hot Flushes in Prostate Cancer

Researchers from University Hospital in Poitiers, France, published a study online at the Lancet Oncology Website that says medroxyprogesterone helps reduce hot flushes in men receiving androgen suppression for prostate cancer.

In a double-blind trial, 919 men were treated for 6 months with 11.25 mg of leuprorelin, an androgen suppressor, for prostate cancer. In the sixth month, the 311 men who requested treatment for hot flushes or reported experiencing 14 or more hot flushes during the preceding week were randomized to receive daily treatment with 75 mg of venlafaxine (n = 102), 20 mg of medroxyprogesterone acetate (n = 108), or 100 mg of cyproterone acetate (n = 101).

To assess the number of hot flushes, patients were asked to record them in a diary for 1 week before randomization. They also completed a quality-of-life questionnaire before each visit. Data were compared to baseline evaluations and assessments at 4 weeks, 8 weeks, and 12 weeks post-randomization. Patients who received at least 1 dose of the study treatment were included in the efficacy analysis; 2 patients were excluded from the efficacy analysis for deviating from protocol.

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Investigators reported a 47% drop in median daily hot flushes 1 month after randomization. Cyproterone and medroxyprogesterone were associated with significantly larger declines in the incidence of hot flushes compared with venlafaxine ( <.001). There was no significant difference in the occurrence of hot flushes between the cyproterone and medroxyprogesterone groups, but the authors noted that “cyproterone is a recognized treatment in prostate cancer and its use could interfere with hormonal therapy.” Thus, they suggested medroxyprogesterone be considered as a “standard treatment for men undergoing androgen suppression for prostate cancer.”

Five patients in the medroxyprogesterone group experienced serious adverse effects compared with 4 in the venlafaxine group and 7 in the cyproterone group. They noted that the short follow-up in the study and the potential effect of steroidal antiandrogens on prostate cancer were limitations to this study.