ANTIANDROGENE: WIRKUNGSWEISE UND KLINISCHE ANWENDUNG

Recent advances in the understanding of androgenic action have provided new therapeutic approaches to the treatment of carcinoma of the prostate and benign prostatic hypertrophy. The effect of androgens on target tissues can be inhibited by one of three mechanisms: suppression of pituitary LH release, thereby inhibiting testosterone production by the testes; direct inhibition of steroidogenesis by the Leydig cell; and inhibition of androgenic action at target tissues. Antiandrogenic agents have been classified relative to their site of action. Clinically, in men with carcinoma of the prostate antiandrogens have proven effective in the management of patients with reactivation of symptoms following castration. Subjective and objective evidence of remission has been demonstrated. In the treatment of benign prostatic hypertrophy, although symptomatic improvement has been reported with a variety of agents, it has been difficult to prove whether predictable benefit has been achieved. Hopefully, future studies utilizing more potent agents will provide convincing evidence.