Clinical applications of somatostatin analogs for growth hormone-secreting pituitary adenomas

被引:13
|
作者
Wang, Ji-wen [1 ,2 ,3 ]
Li, Ying [4 ]
Mao, Zhi-gang [1 ,2 ,3 ]
Hu, Bin [1 ,2 ,3 ]
Jiang, Xiao-bing [1 ,2 ,3 ]
Song, Bing-bing [5 ]
Wang, Xin [5 ]
Zhu, Yong-hong [5 ]
Wang, Hai-jun [1 ,2 ,3 ]
机构
[1] Sun Yat Sen Univ, Affiliated Hosp 1, Dept Neurosurg, Guangzhou 510080, Guangdong, Peoples R China
[2] Sun Yat Sen Univ, Affiliated Hosp 1, Pituitary Tumor Ctr, Guangzhou 510080, Guangdong, Peoples R China
[3] Sun Yat Sen Univ, Zhongshan Ophthalm Ctr, Key Lab Pituitary Adenoma Guangdong Prov, Guangzhou 510080, Guangdong, Peoples R China
[4] Sun Yat Sen Univ, Zhongshan Ophthalm Ctr, State Key Lab Ophthalmol, Guangzhou 510080, Guangdong, Peoples R China
[5] Sun Yat Sen Univ, Zhongshan Sch Med, Dept Histol & Embryol, Guangzhou 510080, Guangdong, Peoples R China
来源
PATIENT PREFERENCE AND ADHERENCE | 2014年 / 8卷
基金
中国国家自然科学基金;
关键词
GH-secreting pituitary adenoma; somatostatin analogs; lanreotide ATG; octreotide LAR; growth hormone; insulin-like growth factor 1; PREOPERATIVE OCTREOTIDE TREATMENT; LANREOTIDE LANREOTIDE AUTOGEL; LONG-ACTING FORMULATION; FOLLOW-UP; ACROMEGALIC PATIENTS; FACTOR-I; TRANSSPHENOIDAL SURGERY; TUMOR VOLUME; GH SECRETION; TERM SAFETY;
D O I
10.2147/PPA.S53930
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Excessive growth hormone (GH) is usually secreted by GH-secreting pituitary adenomas and causes gigantism in juveniles or acromegaly in adults. The clinical complications involving cardiovascular, respiratory, and metabolic systems lead to elevated morbidity in acromegaly. Control of serum GH and insulin-like growth factor (IGF) 1 hypersecretion by surgery or pharmacotherapy can decrease morbidity. Current pharmacotherapy includes somatostatin analogs (SAs) and GH receptor antagonist; the former consists of lanreotide Autogel (ATG) and octreotide long-acting release (LAR), and the latter refers to pegvisomant. As primary medical therapy, lanreotide ATG and octreotide LAR can be supplied in a long-lasting formulation to achieve biochemical control of GH and IGF-1 by subcutaneous injection every 4-6 weeks. Lanreotide ATG and octreotide LAR provide an effective medical treatment, whether as a primary or secondary therapy, for the treatment of GH-secreting pituitary adenoma; however, to maximize benefits with the least cost, several points should be emphasized before the application of SAs. A comprehensive assessment, especially of the observation of clinical predictors and preselection of SA treatment, should be completed in advance. A treatment process lasting at least 3 months should be implemented to achieve a long-term stable blood concentration. More satisfactory surgical outcomes for noninvasive macroadenomas treated with presurgical SA may be achieved, although controversy of such adjuvant therapy exists. Combination of SA and pegvisomant or cabergoline shows advantages in some specific cases. Thus, an individual treatment program should be established for each patient under a full evaluation of the risks and benefits.
引用
收藏
页码:43 / 51
页数:9
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