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多中心、观察性研究:兰瑞肽微球在德国、奥地利和瑞士的常规临床实践中治疗肢端肥大症患者。

Multicenter, Observational Study of Lanreotide Autogel for the Treatment of Patients with Acromegaly in Routine Clinical Practice in Germany, Austria and Switzerland.

机构信息

Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, München, Germany.

Amedes VZ, Hamburg.

出版信息

Exp Clin Endocrinol Diabetes. 2021 Mar;129(3):224-233. doi: 10.1055/a-1247-4713. Epub 2020 Dec 7.

Abstract

BACKGROUND

Evidence from controlled trials has shown that lanreotide autogel is effective in achieving biochemical and symptom control in patients with acromegaly. However, it is important to better understand the real-world patient population receiving lanreotide autogel treatment.

METHODS

In this non-interventional study the long-term treatment response to lanreotide autogel in adult patients with acromegaly from office-based centers or clinics in Germany, Austria and Switzerland was studied. Assessments included growth hormone and insulin-like growth factor-I levels, symptoms, quality of life, lanreotide plasma levels and tumor somatostatin receptor subtype expression. The primary endpoint was achievement of full biochemical control, defined as growth hormone ≤2.5 µg/L and insulin-like growth factor I normalization at month 12.

RESULTS

76 patients were enrolled from 21 sites. 7/51 (13.7%) patients of the efficacy population had full biochemical control at baseline, 15/33 (45.5%) at month 12 and 10/26 (38.5%) at month 24 of treatment. At 12 months of treatment higher rates of biochemical control were observed in the following subgroups: older patients (>53 years [median]), females, treatment-naïve patients, and patients with a time since diagnosis of longer than 1.4 years (median). No clinically relevant differences in acromegaly symptoms or quality of life scores were observed. Median fasting blood glucose and glycated hemoglobin levels remained unchanged throughout the study. No new safety signals were observed. Overall tolerability of treatment with lanreotide autogel was judged by 80.8% of the enrolled patients at month 12 as 'very good' or 'good'.

CONCLUSION

Treatment with lanreotide autogel in a real-world setting showed long-term effectiveness and good tolerability in patients with acromegaly.

摘要

背景

对照临床试验的证据表明,兰瑞肽长效微球对控制肢端肥大症患者的生化指标和症状有效。然而,了解接受兰瑞肽长效微球治疗的真实世界患者人群非常重要。

方法

在这项非干预性研究中,研究了德国、奥地利和瑞士的门诊或诊所的成年肢端肥大症患者接受兰瑞肽长效微球的长期治疗反应。评估包括生长激素和胰岛素样生长因子-1 水平、症状、生活质量、兰瑞肽血浆水平和肿瘤生长抑素受体亚型表达。主要终点是达到完全生化控制,定义为生长激素≤2.5μg/L 和胰岛素样生长因子 I 在第 12 个月正常化。

结果

从 21 个地点共招募了 76 名患者。疗效人群中,7/51(13.7%)名患者在基线时达到完全生化控制,15/33(45.5%)名患者在治疗第 12 个月时达到,10/26(38.5%)名患者在治疗第 24 个月时达到。在 12 个月的治疗中,以下亚组观察到更高的生化控制率:年龄较大的患者(>53 岁[中位数])、女性、初治患者和诊断后时间超过 1.4 年的患者(中位数)。未观察到肢端肥大症症状或生活质量评分的临床相关差异。整个研究期间,空腹血糖和糖化血红蛋白水平保持不变。未观察到新的安全性信号。在第 12 个月时,80.8%的入组患者判断兰瑞肽长效微球治疗的总体耐受性为“非常好”或“好”。

结论

在真实环境中使用兰瑞肽长效微球治疗肢端肥大症患者具有长期有效性和良好的耐受性。

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