madman
Super Moderator
INTRODUCTION AND OBJECTIVE
Both clomiphene citrate and its isomer, enclomiphene, have become increasingly widespread within urologic practice; thus, understanding these medications' comparative benefits and risks is crucial for optimizing treatment decisions and providing improved therapeutic options. We sought to investigate the benefits and risks associated with enclomiphene, compared to clomiphene.
METHODS
We retrospectively reviewed patients at our center from 01/01/2021-12/21/2022. All included patients were prescribed clomiphene before switching to enclomiphene. We documented baseline laboratory values before starting clomiphene, followed by subsequent values for each variable in the most recent visit before stopping clomiphene and any noted adverse effects experienced during this time. We next repeated these methods of documenting the same outcomes for the same patients in their most recent visit while taking enclomiphene. Adverse events were defined by 1) depressive thoughts; 2) weak muscle strength; 3) gynecomastia; 4) mood changes; or 5) agitation, as well as changes in estradiol and hematocrit laboratory values. Two-tailed T-Tests were employed using R as well as a regression analysis to estimate the odds ratio (OR) for adverse events between the two therapies.
RESULTS
Among 66 patients, enclomiphene exhibited a median testosterone increase of 166 ng/dl (p=0.200) with lower estradiol change than clomiphene (–5.92 pg/ml vs. 17.50 pg/ml, p=0.001). Adverse effects were significantly less frequent with enclomiphene, including decreased libido (p=0.001), reduced energy (p=0.044), and mood changes (p=0.029). Regression analysis confirmed lower odds of overall adverse events with enclomiphene (p<0.05).
CONCLUSIONS
Our findings demonstrate that enclomiphene provides the same magnitude of improvement in testosterone levels with a lower rate of documented adverse events. These findings support enclomiphene as a comparable treatment option for hypogonadal men while minimizing the risk of adverse effects.
Both clomiphene citrate and its isomer, enclomiphene, have become increasingly widespread within urologic practice; thus, understanding these medications' comparative benefits and risks is crucial for optimizing treatment decisions and providing improved therapeutic options. We sought to investigate the benefits and risks associated with enclomiphene, compared to clomiphene.
METHODS
We retrospectively reviewed patients at our center from 01/01/2021-12/21/2022. All included patients were prescribed clomiphene before switching to enclomiphene. We documented baseline laboratory values before starting clomiphene, followed by subsequent values for each variable in the most recent visit before stopping clomiphene and any noted adverse effects experienced during this time. We next repeated these methods of documenting the same outcomes for the same patients in their most recent visit while taking enclomiphene. Adverse events were defined by 1) depressive thoughts; 2) weak muscle strength; 3) gynecomastia; 4) mood changes; or 5) agitation, as well as changes in estradiol and hematocrit laboratory values. Two-tailed T-Tests were employed using R as well as a regression analysis to estimate the odds ratio (OR) for adverse events between the two therapies.
RESULTS
Among 66 patients, enclomiphene exhibited a median testosterone increase of 166 ng/dl (p=0.200) with lower estradiol change than clomiphene (–5.92 pg/ml vs. 17.50 pg/ml, p=0.001). Adverse effects were significantly less frequent with enclomiphene, including decreased libido (p=0.001), reduced energy (p=0.044), and mood changes (p=0.029). Regression analysis confirmed lower odds of overall adverse events with enclomiphene (p<0.05).
CONCLUSIONS
Our findings demonstrate that enclomiphene provides the same magnitude of improvement in testosterone levels with a lower rate of documented adverse events. These findings support enclomiphene as a comparable treatment option for hypogonadal men while minimizing the risk of adverse effects.
