METABOLIC EFFECTS OF 17-ETHYL-19-NORTESTOSTERONE IN MAN*

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Abstract
TESTOSTERONE is widely used in the treatment of osteoporosis (1, 2) and of metastatic breast carcinoma (3). Improvement in well-being, appetite and general strength, decrease of bone pain, weight gain, recalcification of osteolytic lesions and shrinkage of soft-tissue metastases have been noted. However, hirsutism, acne, change of voice and of libido are disturbing side-reactions. In addition, the hypercalcemic syndrome has been observed in 10–15 per cent of patients with metastatic breast carcinoma who were treated with testosterone; this toxic side-reaction was thought to be due to stimulation of growth of the hormonally dependent tumor (4, 5). In view of these undesirable effects, several testosterone compounds have been assayed in the hope of finding a potent anabolic agent less androgenic than testosterone (6–8). The testosterone derivative 17-ethyl-19-nortestosterone (Nilevar1) was shown to have the greatest separation of androgenic and anabolic effects in rats (9, 10). The favorable ratio of anabolic to androgenic potency in experimental animals suggested the metabolic evaluation of this compound in man. Therefore, Nilevar was administered intramuscularly to 5 patients whose dietary intake was controlled on the metabolic research ward (11). The effects of this agent on protein and mineral metabolism were studied under this experimental arrangement, but no evaluation was made of androgenic potency.