培维索孟在肢端肥大症治疗中的作用。
The role of pegvisomant in the treatment of acromegaly.
作者信息
Roelfsema Ferdinand, Biermasz Nienke R, Pereira Alberto M, Romijn Johannes A
机构信息
Leiden University Medical Center, Department of Endocrinology and Metabolism, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
出版信息
Expert Opin Biol Ther. 2008 May;8(5):691-704. doi: 10.1517/14712598.8.5.691.
BACKGROUND
Expert surgery in acromegaly is curative in about only 60% of cases. Postsurgical radiation therapy is associated with a high incidence of hypopituitarism and its effect on growth hormone decrease is slow. Therefore, effective adjuvant medical treatment is mandatory.
OBJECTIVE
To delineate the role of pegvisomant in the treatment of acromegaly.
METHODS
A search of the Medline, Embase and Web of Science databases for clinical studies on pegvisomant was performed. In addition, abstracts of the major endocrine society meetings in 2007 were searched.
RESULTS
When treatment with somatostatin analogues after non-curative surgery does not lead to normalisation of serum IGF-I and growth hormone concentrations, pegvisomant alone or in combination with somatostatin analogues can control disease in a substantial number of patients. The most important side effects are disturbed liver function tests and, rarely, growth of the adenoma. The efficacy in non-operated patients and the long-term safety have yet to be ascertained.
背景
肢端肥大症的专业手术仅在约60%的病例中具有治愈性。术后放射治疗与垂体功能减退的高发生率相关，并且其对生长激素降低的作用缓慢。因此，有效的辅助药物治疗是必需的。
目的
阐明培维索孟在肢端肥大症治疗中的作用。
方法
对Medline、Embase和科学引文索引数据库进行检索，以查找有关培维索孟的临床研究。此外，还检索了2007年主要内分泌学会会议的摘要。
结果
在非治愈性手术后使用生长抑素类似物治疗未能使血清胰岛素样生长因子-I（IGF-I）和生长激素浓度恢复正常时，单独使用培维索孟或与生长抑素类似物联合使用可使大量患者的病情得到控制。最重要的副作用是肝功能检查结果异常，腺瘤生长则较为罕见。其在未接受手术患者中的疗效和长期安全性尚待确定。
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