Predictors of the effectiveness of drug therapy of acromegaly (according to the Moscow register)
- 作者: Antsiferov M.B1, Pronin V.S.1, Alekseeva T.M1, Pronin V.S2
-
隶属关系:
- Endocrinological Dispensary of the Moscow Healthcare Department
- Russian Medical Academy of Continuous Professional Education
- 期: 卷 27, 编号 4 (2020)
- 页面: 50-56
- 栏目: Articles
- URL: https://journals.eco-vector.com/2073-4034/article/view/312545
- DOI: https://doi.org/10.18565/pharmateca.2020.4.50-56
- ID: 312545
如何引用文章
详细
Background. Acromegaly is a chronic multiorgan disease that adversely affects the quality and life expectancy of the patient. Created in 2003, the Moscow register of patients with acromegaly and pituitary gigantism serves as an example of a multidisciplinary approach to solving the problem of managing rare diseases with the organization of a modern diagnostic and treatment base, the continuity of treatment, and effective drug provision. Despite the successes achieved in the treatment of acromegaly, however, the problem of adequate medication remains due to the presence of multiple pathomorphological variants of GH-secreting tumors that affect drug sensitivity. Objective. Analysis of the results of long-term primary and secondary drug therapy (DT) with the identification of possible predictors of effective treatment. Methods. The data of 484 patients (139 men, 345 women) who received multiannual primary or secondary DT with first-generation somatostatin analogues (SA1) are presented. The dopamine agonist cabergoline was used in cases of low secretory activity of the disease, the presence of mixed (GH- and prolactin-secreting tumors), as well as in the detection of relative resistance to SA1. Results. When conducting primary and secondary DT, sensitivity to AC1, assessed by the gradient of a decrease in the insulin-like growth factor-1 level after 3 and 12 months of treatment, is considered a predictive predictor of successful medical benefits. It is assumed that these cut-off points can be used to address the issue of maintaining or changing treatment tactics. Conclusion. Further improvement of knowledge about biomarkers characterizing the status and state of GH-secreting adenomas opens up prospects for predicting tumor development scenarios and for providing differentiated therapeutic benefits for acromegaly syndrome.
全文:
![受限制的访问](https://journals.eco-vector.com/lib/pkp/templates/images/icons/text_lock.png)
作者简介
M. Antsiferov
Endocrinological Dispensary of the Moscow Healthcare Department
Vyacheslav Pronin
Endocrinological Dispensary of the Moscow Healthcare Department
Email: vspronin@yandex.ru
Dr.Sci. (Med.), Professor at the, Department of Endocrinology
T. Alekseeva
Endocrinological Dispensary of the Moscow Healthcare Department
V. Pronin
Russian Medical Academy of Continuous Professional Education
参考
- Lavrentaki A., Paluzzi A., Wass J.A., Karavitaki N. Epidemiology of acromegaly: review of population studies. Pituitary. 2017;20(1):4-9. Doi: 10.1007/ s11102-016-0754-x
- Burton T, Le Nestour E, Neary M, Ludlam W.H. Incidence and prevalence of acromegaly in a large US health plan database. Pituitary. 2016;19(3):262 67. doi: 10.1007/s11102-015-0701-2
- Syro L.V, Rotondo F, Serna C.A., et al. Pathology of GH-producing pituitary adenomas and GH cell hyperplasia of the pituitary. Pituitary. 2017;20(1):84-92. doi: 10.1007/511102-0160748-8.
- Butz L.B, Sullivan S.E., Chandler W.F., Barcan A.L. «Micromegaly»: an update on the prevalence of acromegaly with apparently normal GH secretion in the modern era. Pituitary. 2016;19(6):547-51. doi: 10.1007/s11102-016-0735-0.
- Khairi S., Sagvand B.T, Pulaski-Liebert K.J., et el. patients with acromegaly: an 8-year follow-up of a lanreotidestudy. Endocrpract. 2017;23(1):56-65. doi: 10.4158/EP161439.0R.
- Salvatory R., Gordon M.B. Woodmansee W.W., et al. A multicenter, observational study of lanreotide depot/autogel (LAN) in patients with acromegaly in the United States: 2-year experience from the SODA registry. Pituitary. 2017;20(6):605-18. doi: 10.1007/s11102-017-0821-y.
- Witek P., Mucha S., Ruchala M. Patient satisfaction and preferences of lanreotide Autogel treatment in acromegaly. Endocrnol Pol. 2016;67(6):572-79. doi: 10.5603/EP2016.0066.
- Akirov A., Asa S.L., Amer L., et al. The Clinicopathological Spectrum of Acromegaly. J Clin Med. 2019;8(11). doi: 10.3390/jcm8111962.
- Cuevas-Ramos D., Carmichael J.D., Cooper O., et al. A structural and functional acromegaly classification. J Clin Endocrinol Metab. 2015;100(1):122-31. doi: 10.1210/jc.2014-2468.
- Melmed S., Bronstein M.D., Chanson P, et al. A Consensus Statement on acromegaly therapeutic outcomes. Nat Rev Endocrinol. 2018;14(9):552 61. doi: 10.1016/s0009-9120(75)91675-6
- Gadelha M.R., Wildemberg L.E., Bronstein M.L., et al. Somatostatin receptor ligands in the treatment of acromegaly. Pituitary. 2017;20(1):100-8. doi: 10.1007/s11102-017-0791-0.
- Puig-Domingo M., Resmini E., Gomez-Anson B., et al. Magnetic resonance imaging as a predictor of response to somatostatin analogs in acromegaly after surgical failure. J Clin Endocrinol Metab. 2010;95:4973-78. doi: 10.1210/jc.2010-0573.
- Анциферов М.Б., Алексеева Т.М., Пронин В.С. Московский регистр больных акромегалией: отдаленные результаты наблюдения. Фарматека. 2016;16:62-6.
- Анциферов М.Б. и др. Опыт ведения Московского регистра больных акромегалией: возможности решения различных терапевтических задач. Фарматека. 2013;16:42-7.
- Пронин В.С. Диагностические и прогностические факторы, определяющие особенности клиниче ского течения и тактику лечения акромегалии. Дисс. докт. мед. наук. М., 2011,300 с.
- Domingo M.P. Treatment of acromegaly in the era of personalised and predictive medicine. Clin Endocrinol (Oxf). 2015;83(1):3-14. doi: 10.1111/cen.12731.
- Kasuki L., Wildemberg L.E., Gadelha M.R. Management of endocrine disease: Personalized medicine in the treatment of acromegaly Eur J. Endocrinol. 2018;178(3):89-100. Doi: 10.1530/ EJE-17-1006.
- Ezzat S., Caspar-Bell G.M., Chik C.L., et al. Predictive markers for postsurgical medical management of acromegaly: a systematic review and consensus treatment guideline. Endocr Pract. 2019;25(4):379-93.
补充文件
![](/img/style/loading.gif)