Interdisziplinäres Stoffwechsel-Centrum, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, 13353 Berlin, Germany.
Int J Endocrinol. 2012;2012:268957. doi: 10.1155/2012/268957. Epub 2012 Apr 10.
This paper outlines the present status of medical therapy of acromegaly. Indications for permanent postoperative treatment, postirradiation treamtent to bridge the interval until remission as well as primary medical therapy are elaborated. Therapeutic efficacy of the different available drugs-somatostatin receptor ligands (SRLs), dopamine agonists, and the GH antagonist Pegvisomant-is discussed, as are the indications for and efficacy of their respective combinations. Information on their mechanism of action, and some pharmakokinetic data are included. Special emphasis is given to the difficulties to define remission criteria of acromegaly due to technical assay problems. An algorithm for medical therapy in acromegaly is provided.
本文概述了肢端肥大症的医学治疗现状。阐述了永久性术后治疗的适应证、放疗后治疗以弥合缓解前的间隔期，以及初始药物治疗。讨论了不同可用药物（生长抑素受体配体[SRL]、多巴胺激动剂和 GH 拮抗剂 Pegvisomant）的治疗效果，以及它们各自联合应用的适应证和疗效。还介绍了它们的作用机制和一些药代动力学数据。特别强调了由于技术检测问题导致定义肢端肥大症缓解标准的困难。提供了肢端肥大症药物治疗的算法。
