- 著者
- Naoya Masumori Mikiya Nakatsuka
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Reports (ISSN:24340790)
- 巻号頁・発行日
- pp.CR-23-0021, (Released:2023-03-28)
- 参考文献数
- 54
- 被引用文献数
- 10
Gender-affirming hormone treatment generally by cross-sex hormones is an important strategy for transgender people to achieve the physical features affirming their experienced gender. Estrogens and androgens are administrated, usually for a long time, to transgender women and transgender men who would like to physically achieve feminization and masculinization, respectively. Several harmful adverse events have been reported in the literature following the administration of gender-affirming hormones, including worsening of lipid profiles and cardiovascular events (CVE) such as venous thromboembolism, stroke, and myocardial infarction, but it remains unknown whether the administration of cross-sex hormones to transgender people increases the subsequent risk of CVE and death. Based on the findings of the present narrative review of the recent literature, including meta-analyses and relatively large-scale cohort studies, it is likely that estrogen administration increases the risk of CVE in transgender women, but it remains inconclusive as to whether androgen administration increases the risk of CVE in transgender men. Thus, definitive evidence guaranteeing the long-term safety of cross-sex hormone treatment on the cardiovascular system is insufficient because of lack of evidence from well-organized, high-quality, and large-scale studies. In this situation, as well as considering the proper use of cross-sex hormones, pretreatment screening, regular medical monitoring, and appropriate intervention for risk factors of CVE are necessary to maintain and improve the health of transgender people.
- 著者
- Katsuyuki Nakamura Toshiaki Tanaka Naoya Masumori Atsushi Miyamoto Takeshi Hirano
- 出版者
- The Pharmaceutical Society of Japan
- 雑誌
- Biological and Pharmaceutical Bulletin (ISSN:09186158)
- 巻号頁・発行日
- vol.43, no.10, pp.1506-1510, 2020-10-01 (Released:2020-10-01)
- 参考文献数
- 24
- 被引用文献数
- 7
The usefulness of the urine protein : creatine ratio (UPCR) in management of molecular targeted therapy and immunotherapy has not been studied, although urine protein dipstick testing (uPr) is widely used in the clinical setting. The aim of this study was to investigate the usefulness of UPCR as compared to uPr in patients undergoing molecular targeted therapy for advanced renal cell carcinoma (RCC). A total of 25 patients (median age 68 years) with advanced RCC were included. Sunitinib, pazopanib, axitinib, sorefenib, everolimus, and nivolumab were administered to 15, 9, 16, 3, 7, and 13 patients, respectively, with duplication. Proteinuria was managed according to the grade determined by UPCR. Data at every treatment visit were retrospectively collected and uPr and UPCR were compared. The overall incidences of any grade of proteinuria associated with sunitinib, pazopanib, axitinib, sorafenib and everolimus were 86.7, 88.9, 93.8, 100, and 85.7%, respectively. There were discordances between the uPr-based grade and UPCR-based grade. UPCR did not meet the criteria of Grade 3 in 70.6, 100, 83.3, and 83.3% at visits in cases with uPr 3+ for sunitinib, pazopanib, sorafenib, and everolimus, respectively. In axitinib treatment, UPCR did not meet the criteria for withholding in 46.2% of the cases of uPr 2+ and more. Our study suggests that UPCR may be useful tool in management of adverse events associated with tyrosine kinase inhibitors, everolimus and can provide patients with optimal opportunities for receiving treatment.