Glucose homeostasis and safety in patients with acromegaly converted from long-acting octreotide to pegvisomant
Glucose homeostasis and safety in patients with acromegaly converted from long-acting octreotide to pegvisomant
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DOI：
10.1210/jc.2005-0331
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发表时间：
2005-10-01
影响因子：
5.8
通讯作者：
Vance, ML
中科院分区：
文献类型：
--
作者：
Barkan, AL;Burman, P;Vance, ML
背景：在临床实践中，肢端肥大症患者可能会从长效生长抑素类似物治疗转向pegvisomant。改变治疗方法对葡萄糖稳态和安全性的影响尚未报道。目的：本研究的目的是监测igf - 1水平、血糖控制和安全性的变化，特别是肝功能和肿瘤大小。设计：这是一项多中心、开放标签、32周的试验研究。环境：研究在门诊进行。患者：53例既往接受奥曲肽长效释放（LAR）治疗的肢端肥大症患者参加了本研究。干预：Pegvisomant （10mg /d）在最后一次奥曲肽LAR治疗后第4周开始，并根据第12、20和28周的血清IGF-I浓度进行调整。主要结局指标：主要结局指标为转化后前12周IGF-I、糖化血红蛋白A(1c) （HbA(1c)）、空腹血糖和安全性的变化。结果：在pegvisomant治疗结束时，78%的患者IGF-I恢复正常。在第32周，中位空腹葡萄糖浓度和HbA（1c）分别降低（-1.4 mmol/l和-0.4%）
Context: In clinical practice, patients with acromegaly may be switched from therapy with long-acting somatostatin analogs to pegvisomant. The effect of changing therapies on glucose homeostasis and safety has not been reported.Objectives: The objectives of this study were to monitor changes in IGF-I levels, glycemic control, and safety, particularly liver function and tumor size.Design: This was a multicenter, open-label, 32-wk trial study.Setting: The study was performed at outpatient clinics.Patients: Fifty-three patients with acromegaly previously treated with octreotide long-acting release (LAR) participated in this study.Intervention: Pegvisomant (10 mg/d) was initiated 4 wk after the last dose of octreotide LAR and was adjusted based on serum IGF-I concentrations at wk 12, 20, and 28.Main Outcome Measures: The main outcome measures were changes in IGF-I, glycosylated hemoglobin A(1c) (HbA(1c)), fasting plasma glucose, and safety during the first 12 wk after conversion.Results: At the end of pegvisomant treatment, IGF-I was normalized in 78% of patients. At wk 32, median fasting glucose concentration and HbA(1c) were reduced (-1.4 mmol/liter and -0.4%, respectively; both P