Raloxifene decreases serum IGF-I in male patients with active acromegaly
Raloxifene decreases serum IGF-I in male patients with active acromegaly
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DOI：
10.1530/eje.0.1500481
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发表时间：
2004-04-01
影响因子：
5.8
通讯作者：
Barkan, AL
中科院分区：
文献类型：
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作者：
Dimaraki, EV;Symons, KV;Barkan, AL
目的：大多数肢端肥大症患者在经蝶手术后需要额外的治疗。虽然传统的治疗方法旨在抑制垂体瘤的GH分泌过多，但最近使用GH受体拮抗剂的研究表明，靶向GH对外周组织的作用可能更有效。雌激素和选择性雌激素受体调节剂他莫昔芬以前曾用于抑制肢端肥大症患者的循环IGF-I水平。雷洛昔芬的积极作用，妇女与活动性肢端肥大症最近已报告。本研究的目的是探讨雷洛昔芬在男性patients.Design治疗肢端肥大症的潜在作用：我们研究了8名男性活动性肢端肥大症，尽管他们正在接受传统的治疗。所有受试者与雷洛昔芬（60毫克，每天两次）的中位数为5 weeks.Methods：雷洛昔芬对生长激素分泌的影响进行了评估，获得24小时生长激素的档案和研究生长激素对各种刺激治疗雷洛昔芬前后。结果：雷洛昔芬不影响基础GH分泌或GH对TRH、GHRH或葡萄糖的反应，但可使循环IGF-I降低16 ± 4%（P = 0.001），并使2例患者的血浆IGF-I恢复正常。未观察到临床参数变化。催乳素水平、催乳素对TRH的反应和游离睾酮水平保持不变。结论：雷洛昔芬治疗男性活动性肢端肥大症可能是有效的，但显然需要更长期的研究。
Objective: Most patients with acromegaly require additional treatments after trans-sphenoidal surgery. Although traditional methods of treatment aim at suppressing GH hypersecretion from the pituitary tumor, recent studies on the use of the GH receptor antagonist have shown that targeting the action of GH on peripheral tissues may be more effective. Estrogens and the selective estrogen receptor modulator tamoxifen have been used previously to suppress circulating IGF-I levels in patients with acromegaly. Positive effects of raloxifene in women with active acromegaly have been reported recently. This study was designed to examine the potential role of raloxifene in the treatment of acromegaly in male patients.Design: We studied eight men with active acromegaly despite the fact that they were receiving traditional treatments. All subjects were treated with raloxifene (60 mg twice a day) for a median of 5 weeks.Methods: The effects of raloxifene on GH secretion were assessed by obtaining 24-h GH profiles and studying the response of GH to various stimuli before and after treatment with raloxifene. Serum IGF-I was measured before and after raloxifene treatment.Results: Raloxifene did not affect basal GH secretion or response of GH to TRH, GHRH or glucose, but it decreased circulating IGF-I by 16 +/- 4% (P = 0.001), and normalized plasma IGF-I in two patients. No changes in clinical parameters were observed. Prolactin levels, the prolactin response to TRH and free testosterone levels remained unchanged. Raloxifene was well tolerated.Conclusion: Raloxifene might be useful in the treatment of male patients with active acromegaly, but longer term studies are clearly needed.