The endocrine effects of low dose (62.5 mg, twice a day) aminoglutethimide (AG), without hydrocortisone (HC), escalating at monthly intervals to a conventional dose of AG (500 mg twice a day) combined with HC, were studied in 33 postmenopausal breast cancer patients. Pretreatment serum concentrations of oestrone (E1) and oestradiol (E2) were significantly suppressed by 62.5 mg of AG twice a day. Although further suppression of E1 appeared to occur with 125 mg of AG twice a day, this was not statistically significant. For E1 and E2, higher doses of AG or combined AG and HC failed to cause further significant suppression compared with that obtained at 125 mg of AG twice a day. Significant rises in serum androstenedione were found with all doses of AG alone, although pretreatment concentrations of androstenedione were not significantly altered by combined AG and HC treatment. Mean pretreatment concentrations of dehydroepiandrosterone sulphate (DHA-S) were significantly suppressed by 62.5 mg of AG twice a day and further marked suppression occurred on combined AG and HC therapy. Serum cortisol, aldosterone and plasma ACTH concentrations showed no significant alterations throughout treatment. Aminoglutethimide is as effective at 125 mg twice a day without HC in its suppression of oestrogen levels as at 500 mg twice a day with HC, and its use in this form warrants clinical evaluation.

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Objectives: Incremental health care resource utilization associated with autosomal dominant polycystic kidney disease (ADPKD) was estimated across two subgroups; individuals with ADPKD and end-stage renal disease (ESRD) and those with ADPKD but without ESRD. MethOds: Study data were from a large administrative claims and enrollment database. Individuals 18 y/o or older, enrolled in tracked health plans for 12 months from April 1, 2011 through March 31, 2012, and with an ICD-9-CM diagnosis code for "polycystic kidney, autosomal dominant" (753.13) or for "polycystic kidney, unspecified type (753.12) were identified as having ADPKD, and linked one-to-one with individuals without ADPKD on age and gender. ESRD was identified by presence of ICD-9-CM code 585.6. Zero-inflated negative binomial models estimated incremental hospitalizations, hospital days, outpatient visits, and emergency room visits for each sub-group, adjusting for age, gender, Charlson co-morbidity index, cardiovascular disease, diabetes and geographical region. Results: A total of 3,844 individuals with ADPKD who satisfied selection criteria were linked one-to-one with 3,844 individuals without ADPKD. Among persons with ADPKD, 644 had a diagnosis of ESRD. The sample was 53% female and 55% were between 45 to 64 years old. Incremental mean (standard error) resource utilization associated with ADPKD with ESRD as compared to persons without ADPKD was 0.35 (0.052) or 35 additional hospitalizations per 100 patients, 2.5 (0.42) or 250 hospital days per 100 patients, and 24.0 (1.2) or 2,400 outpatient visits per 100 patients. Incremental mean (standard error) resource utilization associated with ADPKD but without ESRD as compared to persons without ADPKD was 0.065 (0.028) or 6.5 additional hospitalizations per 100 patients, 0.5 (0.091) or 50 hospital days per 100 patients, and 4.4 (0.41) or 440 outpatient visits per 100 patients. cOnclusiOns: ADPKD was associated with incrementally greater health care resource utilization even before patients reached ESRD.

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