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2019 年德国肢端肥大症的医学治疗 - 德国肢端肥大症登记处的数据。

Medical Therapy of Acromegaly in Germany 2019 - Data from the German Acromegaly Registry.

机构信息

Endocrinology in Charlottenburg, Berlin, Germany.

Clinical Trial Centre, University of Leipzig, Leipzig, Germany.

出版信息

Exp Clin Endocrinol Diabetes. 2021 Mar;129(3):216-223. doi: 10.1055/a-1191-2437. Epub 2020 Jun 30.

Abstract

CONTEXT

Acromegaly is a rare disease caused by excessive growth hormone (GH) secretion from pituitary adenomas in most cases. If neurosurgical therapy is contraindicated or not sufficient, medical therapy is the second line therapy.

OBJECTIVE

To describe current medical therapy in acromegaly.

DESIGN & METHODS: Retrospective data analysis from 2732 patients treated in 69 centers of the German Acromegaly Registry. 749 patients were seen within the recent 18 months, of which 420 were on medical therapy (56.1%).

RESULTS

73% of medically treated acromegalic patients had normal/low IGF-1 levels. 57% of patients with non-normalized IGF-1 levels had an IGF-1 value between 1- and 1.25-fold above the upper limit of normal. Most patients (55%) received somatostatin analogs as monotherapy, 12% GH receptor monotherapy, and 9% dopamine agonist therapy. Doses of each medical therapy varied widely, with 120 mg lanreotide LAR every 4 weeks, 30 mg octreotide LAR every 4 weeks, 140 mg pegvisomant per week and 1mg cabergoline per week being the most frequent used regimens. A combination of different medical regimens was used in almost 25% of the patients.

CONCLUSION

The majority of German acromegalic patients receiving medical therapy are controlled according to normal IGF-1 levels.

摘要

背景

肢端肥大症是一种罕见的疾病,由大多数情况下垂体腺瘤过度分泌生长激素(GH)引起。如果神经外科治疗禁忌或不足,医学治疗是二线治疗。

目的

描述肢端肥大症的当前医学治疗方法。

设计和方法

对来自德国肢端肥大症登记处的 69 个中心的 2732 例患者进行回顾性数据分析。最近 18 个月内有 749 例患者就诊,其中 420 例接受了药物治疗(56.1%)。

结果

73%接受药物治疗的肢端肥大症患者的 IGF-1 水平正常/低。57% IGF-1 水平未正常的患者 IGF-1 值在正常上限的 1-1.25 倍之间。大多数患者(55%)接受了生长抑素类似物单药治疗,12%接受了 GH 受体单药治疗,9%接受了多巴胺激动剂治疗。每种药物治疗的剂量差异很大,最常用的方案为每 4 周注射 120mg 兰瑞肽 LAR、每 4 周注射 30mg 奥曲肽 LAR、每周注射 140mg 培维索孟和每周注射 1mg 卡麦角林。近 25%的患者使用了不同药物治疗方案的组合。

结论

德国接受药物治疗的肢端肥大症患者中,大多数根据正常 IGF-1 水平得到控制。

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