Cyclofenil as a possible cause of non-arteritic anterior ischaemic optic neuropathy.

A 27-year-old woman receiving the steroid drug cyclofenil as a fertility adjunct, experienced blurred vision 24 h after missing a dose and taking a double dose to 'catch up' with her therapeutic protocol. She was found to have a non-arteritic anterior ischaemic optic neuropathy with a visual hemifield defect and impaired optic nerve function, which has not since shown any recovery. This case highlights the prothrombotic potential for the drug when used above normal dosing range, and is therefore of great guidance for those initiating it as a fertility treatment, or in unlicensed use.

Acute hepatitis induced by cyclofenil: a case report.

The case of a 47-year old woman suffering from acute hepatitis caused by cyclofenil, a drug proposed for the treatment of anovulation and scleroderma, is presented. Hepatitis developed seven weeks after the beginning of administration of the drug and its course was reversible after withdrawal. The case is documented on the basis of liver histology and the exclusion of other causes of acute hepatitis.

Long-term evaluation of penicillamine or cyclofenil in systemic sclerosis. Results from a two-year randomized study.

In a two-year prospective therapeutic trial 13 patients with systemic sclerosis (SSc) were treated with penicillamine, 9 with cyclofenil, and 7 with neither. At entry skin involvement and esophageal, lung, heart, and kidney function did not differ significantly between the groups. Reevaluation after one and two years did not show any significant changes in skin, esophageal, heart, and kidney manifestations, while lung function had slightly improved in both drug-treatment groups. This study thus shows little overall effect of penicillamine and cyclofenil, although both drugs may arrest worsening of pulmonary dysfunction.

[Cyclofenil-induced acute hepatitis. A retrospective diagnosis of a case during acute hepatitis B]. / Epatite acuta da cyclofenil. Diagnosi retrospettiva di un caso in corso di epatite acuta da virus B.

We report a case of acute hepatitis due to cyclofenil retrospectively diagnosed during acute viral hepatitis (HBV). Hepatitis developed 3 months after the beginning of administration and was reversible after withdrawal of the drug. The case is documented on the basis of liver histology and the exclusion of other causes of acute hepatitis.

[Value of cyclofenil in the inhibition of lactation. Efficacy compared to bromocriptine]. / Intérêt du cyclofénil dans l'inhibition de la lactation. Efficacité comparée à celle de la bromocriptine.

The inhibitory effects of cyclofenil and bromocriptine on lactation as well as FSH, prolactin and estradiol levels have been compared in control and treated females. The clinical activity of cyclofenil was lower than that of bromocriptine but was virtually free of side-effects. Cyclofenil and bromocriptine only presented similar hormonal effects at the 20th day ; this suggests that the mechanism of action of cyclofenil is more linked to secondary increases in estrogen levels than to a primary effect. Cyclofenil is of particular value in cases of vascular hypersensitivity yo ergot derivatives and for toxemic patients treated with beta-blockers.

[Acute hepatitis caused by cyclofenil (Ondogyne). Apropos of 2 cases]. / Hépatite aiguë due au cyclofénil (Ondogyne). A propos de deux cas.

We report the cases of two adults suffering from acute hepatitis due to cyclofenil (Ondogyne), a drug proposed for the treatment of dysovulation and scleroderma. Hepatitis developed 30 and 102 days after the beginning of discontinuous administration of the drug. A challenge test was positive in both cases. The course of hepatitis was reversible after withdrawal of the drug. Hepatitis induced by cyclofenil is likely to be due to an hypersensitivity mechanism.

Treatment of primary hyperparathyroidism with cyclofenil--a synthetic stilbestrol derivative with minimal feminizing effects.

In eight patients with primary hyperparathyroidism (HPT) the laboratory effects of cyclofenil, which is a synthetic stilbestrol derivative with weak feminizing effects, were studied over a period of 5-13 weeks. In all the patients there were during treatment clear reductions of the serum calcium levels as well as the urinary excretions of calcium and hydroxyproline. These findings are in accordance with earlier reports that oestrogens reduce bone resorption mediated by parathyroid hormone. It has previously been demonstrated that cyclofenil can be given, on other indications, for several years to both male and female patients without oestrogenic side-effects. This pilot study, therefore, indicates that treatment with cyclofenil might be of value in some cases of primary HPT where surgery is not considered.

Hepatic reactions to cyclofenil.

Thirty patients with hepatic reactions to cyclofenil, a non-steroidal drug with a stimulating effect on ovulation, are reviewed. The liver damage was probably related to metabolic idiosyncrasy, and was reversible in all patients.

Cyclofenil in childhood scleroderma.

Treatment with cyclofenil for 9 months of a 10-year-old girl with localized scleroderma is reported. No clinical improvement was achieved. The drug was discontinued due to hepatotoxicity.

Cyclofenil versus placebo in progressive systemic sclerosis. A one-year double-blind crossover study of 27 patients.

Cyclofenil was evaluated versus placebo in the treatment of progressive systemic sclerosis (PSS, scleroderma) in a 2 x 6-month double-blind crossover study. The mean duration of disease was six years. Of 38 patients entering the study, 27 completed both periods. Reasons for drop-outs were very high liver transaminases in three cases, cardiac death in two, and drug allergy, alcoholic problems, suspected congestive heart failure, reactivation of tuberculosis, arteriosclerotic heart disease, and lethal progression of PSS in one case each. No fatality was attributed to cyclofenil. Liver enzyme abnormalities were seen in 13 of 35 active drug periods and in 5 of 30 placebo periods. Cutaneous and visceral involvement were assessed by a large battery of subjective parameters and objective tests. Overall improvement was seen during 17 drug periods and nine placebo periods (N.S.), but a paired comparison of the status at the end of each treatment period resulted in the following distribution: 15 were improved at the end of the drug period, four at the end of placebo period (p less than 0.01) and eight were unchanged. In patients with a disease duration of five years or less, joint stiffness and pain were less on drug than on placebo treatment (p less than 0.05). In the whole group, oesophageal peristalsis improved (p less than 0.05). Blood folate increased (p less than 0.01). Working capacity was lower after the drug period than after the placebo period (p less than 0.05). Several other parameters, however, did not change significantly. Cyclofenil appears to be a promising drug in the treatment of PSS and should be tested further in controlled long-term studies.

Cyclofenil in the treatment of scleroderma - a general view on the results after treating 29 cases.

Results are presented from an open treatment of 29 patients suffering from progressive systemic sclerosis (PSS) with cyclofenil, an oestrogenlike non-steroid compound with very low oestrogenicity, which was recently claimed to be effective in this disorder. The treatment resulted in significant improvement of the skin condition and regress of ulcerations, Raymaud's phenomenon, joint pain and stiffness. Most of the patients experienced an increased sense of well-being. A slight elevation of ASAT and ALAT was noted in seven patients and weight gain in two. Present data do not permit an assessment of whether the treatment might influence the visceral changes. A multi-centre controlled study is in progress.

Chemical inducers of ovulation: comparative results.

Chemical inducers of ovulation are frequently used to reestablish a normal hypothalamic-ovarian function in the sterile woman. At present, several types are available and it is useful to evaluate comparatively their efficacy. In this paper we present our results in 396 cases treated with some of these drugs. Clomiphene citrate was administered to 307 patient. Ovulation was obtained in 85.99% and pregnancy in 35.50%. There were 16 abortions (14.68%) among the 109 pregnancies obtained. Cisclomiphene was used in 11 cases. The ovulation rate was 81.81%, with 54.5% of pregnancies. Thirty-eight patients were treated with Cyclophenil. Ovulation was obtained in 71.05% of the cases and pregnancy in 23.68%. In forty cases Tamoxifen was administered: the ovulation rate was 95% and the pregnancy rate was 35%, but the abortion rate was 35%. Tolerance was good with all medications. They had similar adverse side effects (mild and rare). None produced overstimulation. With Cyclophenil and specially with Tamoxifen the cycles were longer. The incidence of abortion in the 131 pregnancies obtained was 14.68% with Clomiphene; none with Cisclomiphene; 11.11% with Cyclophenil, and 35.10% with Tamoxifen. We conclude that Clomiphene is the drug which gives the best results at present.

[Ovulation induction by cyclofenil (author's transl)]. / Ovulationsinduktion durch Cyclofenil.

The ovulation-inducing action of cyclofenil was investigated in 135 sexually mature women aged 20--35 years. The patients were only included in the trial if no ovulation in 2 consecutive cycles with the following criteria: basal temperature, cervix score, ascorbic acid retention, basophil count, serum hormone levels, e. g. LH and progesterone and the estrogens in the 24-hour urine could be determined. Ovulation was only considered to have occurred when all the parameters named indicated it. The lack of ovulation was accompanied by amenorrhea in 21 of the 135 patients. The ovulation rate in the 241 cycles observed was 101, corresponding to 42%. In the 114 patients with anovulatory cycles, the ovulation rate in the 184 cycles observed was 95, corresponding to 50%. In the 21 amenorrheic patients, ovulation occurred 6 times in the 57 cycles observed. Nausea or vomiting occurred as side effects in only 2 cases.