Combined therapy with somatostatin analogues and weekly pegvisomant in active acromegaly
Combined therapy with somatostatin analogues and weekly pegvisomant in active acromegaly
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DOI：
10.1016/s0140-6736(05)63011-5
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发表时间：
2005-05-07
期刊：
影响因子：
168.9
通讯作者：
van der Lely, AJ
中科院分区：
文献类型：
--
作者：
Feenstra, J;de Herder, WW;van der Lely, AJ
在大多数肢端肥大症患者中，每天一次的Pegvisomant单药治疗可使胰岛素样生长因子I （IGF-I）浓度恢复正常，但费用非常昂贵。在一项为期42周的剂量发现研究中，我们评估了26例活动性肢端肥大症患者每月一次的长效生长抑素类似物和每周一次的pegvisomant联合使用的疗效。pegvisomant的剂量增加，直到IGF-I浓度正常或达到每周80mg的剂量。在完成42周治疗的19例（95%）患者中，18例IGF-I达到正常浓度，中位周剂量为60mg pegvisomant（范围40-80）。未发现垂体瘤生长的迹象，但在10例患者（38%）中观察到肝酶轻度升高。这种联合治疗是有效的，可能会增加依从性，并可以大大降低一些肢端肥大症患者的医疗费用。
Pegvisomant monotherapy once daily returns concentrations of insulin-like growth factor I (IGF-I) to normal in most patients with acromegaly, but is very costly. In a 42-week dose-finding study, we assessed the efficacy of the combination of long-acting somatostatin analogues once monthly and pegvisomant once weekly in 26 patients with active acromegaly. Dose of pegvisomant was increased until IGF-I concentration became normal or until a weekly dose of 80 mg was reached. IGF-I reached normal concentrations in 18 of 19 (95%) patients who completed 42 weeks of treatment, with a median weekly dose of 60 mg pegvisomant (range 40-80). No signs of pituitary tumour growth were noted, but mild increases in liver enzymes were observed in ten patients (38%). This combined treatment is effective, might increase compliance, and could greatly reduce the costs of medical treatment for acromegaly in some patients.