Lanreotide in the treatment of patients with thyroid eye disease.
Lanreotide in the treatment of patients with thyroid eye disease.
复制标题
兰瑞肽治疗甲状腺眼病患者。
DOI：
10.1530/eje.0.1360416
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发表时间：
1997
影响因子：
5.8
通讯作者：
G. Tolis
中科院分区：
文献类型：
--
作者：
G. Krassas;Themistocles Kaltsas;A. Dumas;N. Pontikides;G. Tolis
奥曲肽是一种有效的合成生长抑素（SM）类似物，最近被评估并发现对甲状腺眼病（TED）有有益作用，主要是在Octreoscan-111阳性的患者中。Lanreotide （LRT; Somatuline-Ipsen）是一种新的SM长效类似物，比天然SM更有效，作用时间更长。本初步研究的目的是评估LRT治疗TED的疗效。5例患者，男3例，女2例，平均年龄50.6±7.6 S.D.（45-64）岁，均有严重的TED症状。年龄、性别和眼病严重程度相匹配的相似数量的患者作为对照。所有患者和对照组均采用111 In DTPA-D-Phe1-octreotide （octreoscan -111）进行眼眶显像调查，并根据octreoscan -111的阳性结果进行选择。本研究采用了Donaldson等人采用的NOSPECS系统（Journal of Clinical Endocrinology and Metabolism 1973 37 276-285）和最近由一个国际研讨会提出的疾病活动性评分，以评估对治疗的反应。治疗组5例患者接受0.04 g LRT静脉滴注，每2周1次，为期3个月，之后重复使用Octreoscan-111。对照组患者静脉注射水1次，每2周1次，连续3个月，术后进行临床评价。对照组未使用Octreoscan-111。所有患者和对照组由同一位医生评估，该医生不知道所使用的治疗类型。NOSPECS评分和临床活动评分的下降被认为是积极反应，而NOSPECS评分没有变化或增加并且没有临床改善被认为是消极反应。LRT治疗3个月后，4例患者双眼眼病改善，1例患者单眼眼病改善，有统计学意义。三名患有TED的对照患者没有表现出任何变化，一名患者的一只眼睛有轻微改善，另一只眼睛没有变化，另一名患者的两只眼睛都出现了恶化。一个有趣的发现是，在LRT治疗后，所有患者的眶Octreoscan-111活性均缺失。总之，这些初步结果表明，LRT对TED患者有有益的作用，并且由于它每2周只能给予一次，因此它可能优于任何其他形式的SM治疗。然而，由于患者数量较少，需要进一步的研究来证实我们的结果。
Octreotide, a potent synthetic somatostatin (SM) analogue, was recently evaluated and found to have a beneficial effect in thyroid eye disease (TED), mostly in those patients with a positive Octreoscan-111. Lanreotide (LRT; Somatuline-Ipsen), a new SM long-acting analogue, is more active than natural SM and shows a much longer duration of action. The aim of the present preliminary study was to evaluate the therapeutic effect of LRT in the treatment of TED. Five patients, three males and two females, mean age 50.6 +/- 7.6 S.D. (45-64) years, all with severe symptoms of TED were studied. A similar number of patients, matched for age, sex and severity of ophthalmopathy served as controls. All the patients and controls were investigated with orbital scintigraphy using 111 In DTPA-D-Phe1-octreotide (Octreoscan-111) and selected on the basis of positive octreoscan. The NOSPECS system, as adapted by Donaldson et al. (Journal of Clinical Endocrinology and Metabolism 1973 37 276-285) and a disease activity score, as proposed recently by an International Workshop, have been followed in this study in order to evaluate the response to treatment. The five patients who comprised the treatment group received 0.04 g LRT i.m. once every 2 weeks over a period of 3 months, after which the Octreoscan-111 was repeated. The control patients were given an injection of water i.m., also once every 2 weeks for 3 months, after which they were evaluated clinically. No Octreoscan-111 was performed in the controls. All patients and controls were evaluated by the same physician, who was unaware of the type of treatment used. A decrease in the NOSPECS score and the clinical activity score was regarded as a positive response, while no change or an increase in the NOSPECS score along with no clinical improvement was regarded as a negative response. After 3 months of treatment with LRT, four patients showed a statistically significant improvement in ophthalmopathy in both eyes and one in one eye. Three of the control patients with TED did not show any change, one showed a minor improvement in one eye and no change in the other and one showed deterioration in both eyes. An interesting finding was that orbital Octreoscan-111 activity was absent in all the patients after LRT treatment. In conclusion, these preliminary results show that LRT has a beneficial effect on patients with TED, and that since it has to be given only once every 2 weeks, it is probably superior to any other form of SM treatment. However, as the number of patients was small, further studies are needed to confirm our results.