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肢端肥大症治疗结果共识:最新进展

Consensus on acromegaly therapeutic outcomes: an update.

作者信息

Melmed Shlomo, di Filippo Luigi, Fleseriu Maria, Mercado Moisés, Karavitaki Niki, Gurnell Mark, Salvatori Roberto, Tsagarakis Stylianos, Losa Marco, Maffei Pietro, Pereira Alberto M, Geer Eliza B, Katznelson Laurence, van der Lely Aart Jan, Bollerslev Jens, Esposito Daniela, Webb Susan M, Zatelli Maria Chiara, Valassi Elena, Neggers Sebastian, Chanson Philippe, Ho Ken K Y, Ioachimescu Adriana G, Biller Beverly M K, Samson Susan L, Kaiser Ursula B, Schilbach Katharina, Luque Raúl M, Casanueva Felipe F, Shimon Ilan, Boguszewski Cesar L, Biermasz Nienke, Colao Annamaria, Pirchio Rosa, Lamberts Steven W J, Kadioglu Pinar, Buchfelder Michael, Frara Stefano, Chiloiro Sabrina, Petersenn Stephan, Gadelha Monica R, Puig-Domingo Manel, Luger Anton, Brue Thierry, Beckers Albert, Ferone Diego, Clemmons David R, Greenman Yona, Marazuela Mónica, Mortini Pietro, Strasburger Christian J, Giustina Andrea

机构信息

Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Institute of Endocrine and Metabolic Sciences, Università San Raffaele Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy.

出版信息

Nat Rev Endocrinol. 2025 Aug 13. doi: 10.1038/s41574-025-01148-2.

Abstract

The 15th Acromegaly Consensus Conference in September 2023 updated recommendations on therapeutic outcomes for acromegaly. Since the publication of medical management guidelines in 2018, new pharmacological agents and new treatment approaches have been developed. Fifty-two experts in the management of acromegaly reviewed the current literature and assessed changes in drug approvals, clinical practice standards and management. Current outcome goals were considered, with a focus on the effect of current and emerging somatostatin receptor ligands, the growth hormone receptor antagonist pegvisomant and the dopamine agonist cabergoline on biochemical control, clinical control, adenoma mass and surgical outcomes. Participants assessed factors that determine pharmacological choices, as well as the proposed use of each agent. Here, we present consensus recommendations highlighting how an evidence-based acromegaly management algorithm could be optimized in clinical practice.

摘要

2023年9月召开的第15届肢端肥大症共识会议更新了关于肢端肥大症治疗结果的建议。自2018年发布医学管理指南以来,已开发出新的药物制剂和新的治疗方法。52位肢端肥大症管理专家审查了当前文献,并评估了药物批准、临床实践标准和管理方面的变化。会议考虑了当前的治疗结果目标,重点关注现有和新兴的生长抑素受体配体、生长激素受体拮抗剂培维索孟以及多巴胺激动剂卡麦角林对生化控制、临床控制、腺瘤大小和手术结果的影响。与会者评估了决定药物选择的因素以及每种药物的建议用法。在此,我们提出共识建议,重点介绍如何在临床实践中优化基于证据的肢端肥大症管理算法。

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