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长效兰瑞肽缓释剂在肢端肥大症药物治疗中的疗效

[Efficacy of delayed-release lanreotide in the medical therapy of acromegaly].

作者信息

Papi G, Magnoni I, Pesenti M, Gola M, Tavernari V, Velardo A

机构信息

Dipartimento di Medicina Interna, Università degli Studi, Modena.

出版信息

Minerva Endocrinol. 1998 Jun;23(2):57-63.

PMID:9844356
Abstract

BACKGROUND

The efficacy of 6 months therapy with slow-release lanreotide (30 mg i.m. every 10-14 days) in 8 acromegalic patients has been studied.

METHODS

These patients had been previously treated (for 62 +/- 5.7 months) with octreotide (100 micrograms t.i.d.) and therefore presented, at the beginning of the study, normal mean GH (3.5 +/- 1.1 ng/ml) and IGF-1 (301.7 +/- 32.9 ng/ml) plasma levels. After a week of wash-out, mean GH (5.5 +/- 1.3 ng/ml) and IGF-1 (523.8 +/- 26.7 ng/ml) plasma levels showed a significant increase (p < 0.01) compared to the values observed during the treatment with octreotide. All 8 acromegalic patients then started the treatment with lanreotide, 30 mg i.m. After 14 days, mean GH plasma levels (4.2 +/- 1.3 ng/ml) did not significantly differ (p = NS) from those observed in the same group of patients during treatment with octreotide, whilst plasma IGF-1 levels (477 +/- 43 ng/ml) were significantly higher (p < 0.05). Four patients, in which mean plasma GH values resulted < 5 ng/ml, continued the therapy with lanreotide every 14 days. In the remaining 4 patients, in which plasma GH values were > 5 ng/ml, lanreotide was administered every 10 days.

RESULTS

After 3 months of therapy, 6 out of the 8 patients presented persistent GH levels < 5 ng/ml during the day, with IGF-1 levels comparable to those observed during treatment with octreotide. The other 2 subjects presented plasma GH levels > 5 ng/ml during the day, with increased plasma levels of IGF-1. This latter group of patients was resubmitted treatment with octreotide, 100 micrograms t.i.d. After 6 months of therapy, all 6 patients presented GH and IGF-1 plasma levels comparable to those observed during treatment with octreotide.

CONCLUSIONS

These data show that slow-release lanreotide can be a valid therapeutic alternative to octreotide in the medical treatment of acromegalic patients.

摘要

背景

研究了8例肢端肥大症患者接受缓释兰瑞肽(每10 - 14天皮下注射30毫克)6个月治疗的疗效。

方法

这些患者此前接受过奥曲肽(每日三次,每次100微克)治疗(62±5.7个月),因此在研究开始时,其血浆生长激素(GH)平均水平正常(3.5±1.1纳克/毫升),胰岛素样生长因子-1(IGF-1)平均水平正常(301.7±32.9纳克/毫升)。经过一周的洗脱期后,与奥曲肽治疗期间观察到的值相比,血浆GH平均水平(5.5±1.3纳克/毫升)和IGF-1平均水平(523.8±26.7纳克/毫升)显著升高(p<0.01)。随后,所有8例肢端肥大症患者开始接受兰瑞肽治疗,皮下注射30毫克。14天后,血浆GH平均水平(4.2±1.3纳克/毫升)与同一组患者接受奥曲肽治疗期间观察到的水平相比无显著差异(p =无统计学意义),而血浆IGF-1水平(477±43纳克/毫升)显著更高(p<0.05)。4例血浆GH平均水平<5纳克/毫升的患者继续每14天接受一次兰瑞肽治疗。其余4例血浆GH水平>5纳克/毫升的患者每10天注射一次兰瑞肽。

结果

治疗3个月后,8例患者中有6例白天GH水平持续<5纳克/毫升,IGF-1水平与奥曲肽治疗期间观察到的水平相当。另外2例患者白天血浆GH水平>5纳克/毫升,血浆IGF-1水平升高。后一组患者重新接受奥曲肽治疗,每日三次,每次100微克。治疗6个月后,所有6例患者的GH和IGF-1血浆水平与奥曲肽治疗期间观察到的水平相当。

结论

这些数据表明,在肢端肥大症患者的药物治疗中,缓释兰瑞肽可以作为奥曲肽的有效治疗替代方案。

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