Primary aldosteronism treated by trilostane (3,β-hydroxysteroid dehydrogenase inhibitor)

• Published in: Urology (Ridgewood, N.J.) Vol. 25; no. 2; pp. 207 - 214
• Main Authors: Nakada, Teruhiro, Kazama, Taizo, Koike, Hiroshi, Yoshikawa, Munehide, Ishikawa, Shigeaki, Katayama, Takashi
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.1985; Elsevier Science
• Subjects: 17-Hydroxycorticosteroids - urine; Adenoma - complications; Adrenal Gland Neoplasms - complications; Adrenal Hyperplasia, Congenital - complications; Adrenocorticotropic Hormone - blood; Adult; Androstenedione - blood; Biological and medical sciences; Dehydroepiandrosterone - blood; Desoxycorticosterone - blood; Dihydrotestosterone - analogs & derivatives; Dihydrotestosterone - therapeutic use; Estradiol - blood; Female; Hormones. Endocrine system; Humans; Hydroxysteroid Dehydrogenases - antagonists & inhibitors; Hyperaldosteronism - drug therapy; Hyperaldosteronism - etiology; Hyperaldosteronism - metabolism; Male; Medical sciences; Middle Aged; Oxidative Phosphorylation Coupling Factors - therapeutic use; Pharmacology. Drug treatments; Progesterone - blood; Radioimmunoassay; Renin-Angiotensin System - drug effects; Testosterone - blood; Endocrinopathy; Human; Chemotherapy; Treatment; Hyperaldosteronism; Primary; Adrenal gland diseases
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/0090-4295(85)90548-5

The practicability and tolerability of trilostane, a competitive inhibitor of 3β-hydroxysteroid-Δ 5-dehydrogenase, for the therapy of primary aldosteronism was assessed in 1 patient with aldosterone-producing adenoma (APA) and 3 subjects with idiopathic adrenal hyperplasia (IHA). Trilostane afforded reduction of plasma levels of aldosterone, progesterone, deoxycorticosterone, 17-OH progesterone, cortisol, Δ 4- androstenedione, and urinary excretion of 17-hydroxycorticosteroid. Conversely, circulating levels of dehydroepiandrosterone, dehydroepiandrosterone sulfate, and urinary excretion of 17-ketosteroids were increased following this drug therapy. Suppression of mineralo- or glucocorticoid biosynthesis was accompanied by an increase in plasma renin activity. One patient with APA or 3 subjects with IHA showed slight or remarkable improvement of hypertension and hypokalemia. Based on these findings, efficacy and tolerability of trilostane appear to aid in the treatment of IHA.