Danazol is a 2,3-isoxazol derivative of 17 α-ethinyl testosterone; it is known to be an anabolic steroid with mild androgenic activity. The administration of the drug is associated with raised plasma levels of several proteins including prealbumin, haptoglobulin, transferrin, antithrombin III, prothrombin, plasminogen, α1-antitrypsin, and Cl esterase inhibitor.1,2 Last year Gralnick and Rick1 reported evidence that danazol was associated with increased levels of factor VIIIc and factor IX and decreased transfusion requirements in patients with hemophilia. Subsequent studies by Gralnick and associates4 as well as other studies by Garewal et al5 are reported in this issue of The Journal and form the basis for this commentary.
The readers of the aforementioned articles are faced with a dilemma in judging the usefulness of danazol in management of hemophilia patients. Gralnick et al report on three of their initial patients plus eight French patients with hemophilia A.