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索马杜林(R)自动凝胶(R),一种用于治疗肢端肥大症患者的新型兰瑞肽制剂

[Somatuline(R) Autogel(R), a new formulation of lanreotide for the treatment of acromegalic patients].

作者信息

Caron P

机构信息

Service d'Endocrinologie et Maladies Métaboliques, CHU Rangueil, 1, avenue J.-Poulhès, 31403 Toulouse, France.

出版信息

Ann Endocrinol (Paris). 2002 Apr;63(2 Pt 3):2S19-24.

Abstract

Lanreotide Autogel((R)) is a new long-acting aqueous preparation of lanreotide for the treatment of acromegaly, and is administered by deep sc injection from small-volume pre-filled syringes. The aim of this study was to evaluate the efficacy and safety of this new long-acting formulation in a large population of acromegalic patients previously responsive to im lanreotide 30mg (sustained release microparticle formulation). Lanreotide Autogel((R)) was administered by deep sc injection every 28 days to 107 patients (54 males, 53 females; mean age 54+/-1.2 years). All patients had been treated with lanreotide 30mg for at least 3 months before study entry, and had a mean GH level<10 ng/mL after at least four subsequent im injections every 14 days (48%), 10 days (32%) or 7 days (20%). Treatment was switched from lanreotide 30mg injected every 14, 10 or 7 days to lanreotide Autogel((R)) 60, 90 or 120mg, respectively, every 28 days. After three fixed-dose injections of lanreotide Autogel((R)), mean lanreotide levels were similar to those obtained at steady state with lanreotide 30mg. During lanreotide Autogel((R)) treatment, the control of acromegalic symptoms was comparable with that previously achieved during lanreotide 30mg treatment. After three injections of lanreotide Autogel((R)), mean values for GH (2.87+/-0.22ng/mL) and IGF-1 (317+/-15ng/mL) were comparable with those recorded at the end of lanreotide 30mg treatment (GH: 2.82 +/- 0.19ng/mL; IGF-1: 323+/-16ng/mL). GH<2.5ng/mL and age-sex-normalised IGF-1 was achieved in 33% and 39% of patients during lanreotide 30mg and lanreotide Autogel((R)) treatment, respectively. Diarrhoea, abdominal pain and nausea were reported by 38, 22 and 18% of patients during lanreotide 30mg treatment, and by 29, 17 and 9% of patients, respectively, during lanreotide Autogel((R)) treatment. In conclusion, this clinical study shows that lanreotide Autogel((R)) is at least as efficacious and well tolerated as lanreotide 30mg. This new long-acting lanreotide formulation, lanreotide Autogel((R)), which is administered from small-volume pre-filled syringes by deep sc injection, is therefore likely to improve the acceptability of medical treatment for patients requiring long-term somatostatin analogue therapy.

摘要

兰瑞肽缓释凝胶(Lanreotide Autogel((R)))是一种用于治疗肢端肥大症的新型长效水性制剂,通过小容量预填充注射器进行深部皮下注射给药。本研究的目的是评估这种新型长效制剂在大量先前对兰瑞肽30mg(缓释微粒制剂)有反应的肢端肥大症患者中的疗效和安全性。兰瑞肽缓释凝胶(Lanreotide Autogel((R)))每28天深部皮下注射给药一次,共纳入107例患者(54例男性,53例女性;平均年龄54±1.2岁)。所有患者在研究入组前均接受兰瑞肽30mg治疗至少3个月,且在随后每14天(48%)、10天(32%)或7天(20%)进行至少四次肌肉注射后,平均生长激素(GH)水平<10 ng/mL。治疗从每14、10或7天注射一次兰瑞肽30mg分别转换为每28天注射一次兰瑞肽缓释凝胶(Lanreotide Autogel((R)))60、90或120mg。在三次固定剂量注射兰瑞肽缓释凝胶(Lanreotide Autogel((R)))后,平均兰瑞肽水平与兰瑞肽30mg稳态时的水平相似。在兰瑞肽缓释凝胶(Lanreotide Autogel((R)))治疗期间,肢端肥大症症状的控制与先前兰瑞肽30mg治疗期间相当。在三次注射兰瑞肽缓释凝胶(Lanreotide Autogel((R)))后,GH(2.87±0.22ng/mL)和胰岛素样生长因子-1(IGF-1,317±15ng/mL)的平均值与兰瑞肽30mg治疗结束时记录的值相当(GH:2.82±0.19ng/mL;IGF-1:323±16ng/mL)。在兰瑞肽30mg和兰瑞肽缓释凝胶(Lanreotide Autogel((R)))治疗期间,分别有33%和39%的患者实现了GH<2.5ng/mL且年龄和性别标准化的IGF-1正常。在兰瑞肽30mg治疗期间,分别有38%、22%和18%的患者报告有腹泻、腹痛和恶心,在兰瑞肽缓释凝胶(Lanreotide Autogel((R)))治疗期间,报告有这些症状的患者分别为29%、17%和9%。总之,这项临床研究表明,兰瑞肽缓释凝胶(Lanreotide Autogel((R)))至少与兰瑞肽30mg一样有效且耐受性良好。这种新型长效兰瑞肽制剂兰瑞肽缓释凝胶(Lanreotide Autogel((R)))通过小容量预填充注射器进行深部皮下注射给药,因此可能会提高需要长期生长抑素类似物治疗的患者对药物治疗的接受度。

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