195例肢端肥大症患者接受胃肠外生长抑素类似物注射后的患者报告结局。
Patient-reported outcomes of parenteral somatostatin analogue injections in 195 patients with acromegaly.
作者信息
Strasburger Christian J, Karavitaki Niki, Störmann Sylvère, Trainer Peter J, Kreitschmann-Andermahr Ilonka, Droste Michael, Korbonits Márta, Feldmann Berit, Zopf Kathrin, Sanderson Violet Fazal, Schwicker David, Gelbaum Dana, Haviv Asi, Bidlingmaier Martin, Biermasz Nienke R
机构信息
Department of Medicine for EndocrinologyDiabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyOxford Centre for DiabetesEndocrinology and Metabolism, Oxford, UKMedizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, GermanyDepartment of EndocrinologyThe Christie, Manchester, UKDepartment of NeurosurgeryUniversity of Erlangen Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Duisburg-Essen, Essen, GermanyPractice for EndocrinologyOldenburg, GermanyEndocrinologyBarts and the London School of Medicine, Queen Mary University, London, UKEndokrinologie and Diabetologie im ZentrumStuttgart, GermanyPhase IV ProgramsBasle, SwitzerlandChiasmaNewton, Massachusetts, USAEndocrine Research LaboratoriesMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, GermanyLeiden University Medical CentreLeiden, The Netherlands
Department of Medicine for EndocrinologyDiabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyOxford Centre for DiabetesEndocrinology and Metabolism, Oxford, UKMedizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, GermanyDepartment of EndocrinologyThe Christie, Manchester, UKDepartment of NeurosurgeryUniversity of Erlangen Nuremberg, Erlangen, GermanyDepartment of NeurosurgeryUniversity of Duisburg-Essen, Essen, GermanyPractice for EndocrinologyOldenburg, GermanyEndocrinologyBarts and the London School of Medicine, Queen Mary University, London, UKEndokrinologie and Diabetologie im ZentrumStuttgart, GermanyPhase IV ProgramsBasle, SwitzerlandChiasmaNewton, Massachusetts, USAEndocrine Research LaboratoriesMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, GermanyLeiden University Medical CentreLeiden, The Netherlands.
出版信息
Eur J Endocrinol. 2016 Mar;174(3):355-62. doi: 10.1530/EJE-15-1042. Epub 2015 Dec 18.
BACKGROUND
Long-acting somatostatin analogues delivered parenterally are the most widely used medical treatment in acromegaly. This patient-reported outcomes survey was designed to assess the impact of chronic injections on subjects with acromegaly.
METHODS
The survey was conducted in nine pituitary centres in Germany, UK and The Netherlands. The questionnaire was developed by endocrinologists and covered aspects of acromegaly symptoms, injection-related manifestations, emotional and daily life impact, treatment satisfaction and unmet medical needs.
RESULTS
In total, 195 patients participated, of which 112 (57%) were on octreotide (Sandostatin LAR) and 83 (43%) on lanreotide (Somatuline Depot). The majority (>70%) of patients reported acromegaly symptoms despite treatment. A total of 52% of patients reported that their symptoms worsen towards the end of the dosing interval. Administration site pain lasting up to a week following injection was the most frequently reported injection-related symptom (70% of patients). Other injection site reactions included nodules (38%), swelling (28%), bruising (16%), scar tissue (8%) and inflammation (7%). Injection burden was similar between octreotide and lanreotide. Only a minority of patients received injections at home (17%) and 5% were self-injecting. Over a third of patients indicated a feeling of loss of independence due to the injections, and 16% reported repeated work loss days. Despite the physical, emotional and daily life impact of injections, patients were satisfied with their treatment, yet reported that modifications that would offer major improvement over current care would be 'avoiding injections' and 'better symptom control'.
CONCLUSION
Lifelong injections of long-acting somatostatin analogues have significant burden on the functioning, well-being and daily lives of patients with acromegaly.
背景
胃肠外注射长效生长抑素类似物是肢端肥大症最广泛使用的药物治疗方法。这项患者报告结局调查旨在评估长期注射对肢端肥大症患者的影响。
方法
该调查在德国、英国和荷兰的9个垂体中心进行。问卷由内分泌学家制定，涵盖肢端肥大症症状、注射相关表现、情绪和日常生活影响、治疗满意度及未满足的医疗需求等方面。
结果
共有195名患者参与，其中112名（57%）使用奥曲肽（善龙），83名（43%）使用兰瑞肽（索马杜林长效注射剂）。尽管接受了治疗，但大多数（>70%）患者仍报告有肢端肥大症症状。共有52%的患者报告其症状在给药间隔期末会加重。注射后持续长达一周的注射部位疼痛是最常报告的注射相关症状（70%的患者）。其他注射部位反应包括结节（38%）、肿胀（28%）、瘀伤（16%）、瘢痕组织（8%）和炎症（7%）。奥曲肽和兰瑞肽的注射负担相似。只有少数患者在家中注射（17%），5%为自我注射。超过三分之一的患者表示因注射而有失去独立性的感觉，16%的患者报告有多次误工天数。尽管注射对身体、情绪和日常生活有影响，但患者对治疗感到满意，但报告称能比当前治疗有重大改善的调整将是“避免注射”和“更好地控制症状”。
结论
终身注射长效生长抑素类似物对肢端肥大症患者的功能、健康和日常生活有重大负担。
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