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长效兰瑞肽治疗格雷夫斯眼病:一项双盲随机、安慰剂对照临床试验。

Slow-release lanreotide in Graves' ophthalmopathy: A double-blind randomized, placebo-controlled clinical trial.

作者信息

Chang T-C, Liao S-L

机构信息

Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

J Endocrinol Invest. 2006 May;29(5):413-22. doi: 10.1007/BF03344124.

Abstract

SS analogs are an attractive alternative in treating Graves' ophthalmopathy (GO). Most of the previous studies were uncontrolled and enrolled few patients. The present study was conducted as a larger scale, prospective, randomized controlled study to determine the effectiveness of a slow-release formulation of lanreotide in GO. Sixty patients with active GO received an im injection every two weeks of either lanreotide 30 mg or placebo for 12 weeks. They were then followed and further treated in the traditional way if necessary. The Clinical Activity Score (CAS) was the primary efficacy criterion. Proptosis, diplopia, corneal erosion or ulcer, visual acuity, extraocular muscle movement and intraocular pressure were also evaluated. At the end of the 12 weeks, the mean CAS was not significantly decreased in the lanreotide group compared to the placebo group. The overall mean difference of proptosis between these two groups also did not reach significance at 12 weeks. Only diplopia at downward gaze had significant improvement for the lanreotide- treated group vs placebo group (p = 0.03). No differences were observed between the two groups compared to other outcome measures. During the 24-month follow-up after the clinical trial, 14 patients received eye surgery in the placebo group compared with 10 patients in the lanreotide group (p = 0.29). Six patients received methylprednisolone pulse therapy in the placebo group and two patients in the lanreotide group (p = 0.25). In conclusion, lanreotide treatment had no significant effects on GO compared with placebo.

摘要

生长抑素类似物是治疗格雷夫斯眼病(GO)的一种有吸引力的替代方法。此前的大多数研究都未设对照且纳入的患者较少。本研究作为一项更大规模的前瞻性随机对照研究,旨在确定兰瑞肽缓释制剂对GO的疗效。60例活动性GO患者每两周接受一次30mg兰瑞肽或安慰剂的肌肉注射,共12周。之后对他们进行随访,必要时按传统方式进一步治疗。临床活动评分(CAS)是主要疗效标准。还评估了眼球突出、复视、角膜糜烂或溃疡、视力、眼外肌运动和眼压。12周结束时,与安慰剂组相比,兰瑞肽组的平均CAS没有显著降低。两组在12周时眼球突出的总体平均差异也未达到显著水平。仅兰瑞肽治疗组向下注视时的复视与安慰剂组相比有显著改善(p = 0.03)。与其他结局指标相比,两组之间未观察到差异。在临床试验后的24个月随访期间,安慰剂组有14例患者接受了眼部手术,兰瑞肽组有10例患者(p = 0.29)。安慰剂组有6例患者接受了甲泼尼龙冲击治疗,兰瑞肽组有2例患者(p = 0.25)。总之,与安慰剂相比,兰瑞肽治疗对GO没有显著效果。

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