TAILIEUCHUNG - Báo cáo y học: "Primary treatment of acromegaly with high-dose lanreotide: a case series"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Primary treatment of acromegaly with high-dose lanreotide: a case series | Wuster et al. Journal of Medical Case Reports 2010 4 85 http content 4 1 85 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Primary treatment of acromegaly with high-dose lanreotide a case series Christian Wuster 1 Stefan Both2 Uwe Cordes1 Wael Omran1 Robert Reisch3 Abstract Introduction The first-line treatment for acromegaly is transsphenoidal surgery. In approximately 50 of patients however a cure is not possible with surgery and alternatives are needed. Somatostatin analog therapy is the recommended first-line treatment in patients with such cases. Here we provide the first report of a high-dose lanreotide primary therapy in patients with acromegaly. Case presentation Six patients who were not suitable for surgery were given 60 mg of lanreotide Autogel every four weeks. All patients were German nationals and Caucasian. When the response of our patients was unsatisfactory the dose was increased sequentially to 90 mg every four weeks 120 mg every four weeks 120 mg every three weeks and 180 mg every three weeks. Treatment duration was 12 to 24 months. In all cases the lanreotide dose was 120 mg every 4 weeks or higher. In five of our patients growth hormone GH levels were successfully reduced in three patients GH ng ml was achieved . Insulin-like growth factor 1 levels were normalized in three patients and decreased in two patients. One patient failed to show a biochemical response to lanreotide therapy or pegvisomant therapy. Tumor shrinkage or degeneration was observed in the five responding patients. No drug-related adverse events were noted. Conclusions These results suggest that lanreotide at high doses of 120 mg every four weeks or more is an effective first-line therapy for patients with acromegaly that surgery alone cannot treat. Introduction Acromegaly characterized by elevated growth hormone GH and insulin-like growth factor 1 IGF-1 levels is associated with a range of cardiovascular respiratory endocrine .

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