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Long-term (up to 18 years) effects on GH/IGF-1 hypersecretion and tumour size of primary somatostatin analogue (SSTa) therapy in patients with GH-secreting pituitary adenoma responsive to SSTa

CONTEXT: The role of somatostatin analogues (SSTa) in the treatment of acromegaly. OBJECTIVE: To evaluate the antihormonal and antitumour efficacy of long-term (up to 18 years) primary treatment with SSTa in patients with GH-secreting pituitary adenoma responsive to SSTa. DESIGN: An open, prospectiv...

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Autores principales: Maiza, Jean Christophe, Vezzosi, Delphine, Matta, Maria, Donadille, Florence, Loubes-Lacroix, Florence, Cournot, Maxime, Bennet, Antoine, Caron, Philippe
Formato: Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1974833/
https://www.ncbi.nlm.nih.gov/pubmed/17524029
http://dx.doi.org/10.1111/j.1365-2265.2007.02878.x
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author Maiza, Jean Christophe
Vezzosi, Delphine
Matta, Maria
Donadille, Florence
Loubes-Lacroix, Florence
Cournot, Maxime
Bennet, Antoine
Caron, Philippe
author_facet Maiza, Jean Christophe
Vezzosi, Delphine
Matta, Maria
Donadille, Florence
Loubes-Lacroix, Florence
Cournot, Maxime
Bennet, Antoine
Caron, Philippe
author_sort Maiza, Jean Christophe
collection PubMed
description CONTEXT: The role of somatostatin analogues (SSTa) in the treatment of acromegaly. OBJECTIVE: To evaluate the antihormonal and antitumour efficacy of long-term (up to 18 years) primary treatment with SSTa in patients with GH-secreting pituitary adenoma responsive to SSTa. DESIGN: An open, prospective, single-centre, clinical study. PATIENTS: Thirty-six acromegalic patients, aged 17–75 years (postoral glucose tolerance test GH > 1 µg/l, increased IGF-1 for age and sex), were monitored in a single centre and treated with SSTa as first-line therapy. The mean pretreatment GH level was 13·5 ±3·1 µg/l, and IGF-1 (as a percentage of the value over the normal range) was 302 ± 26%. The patients had macroadenoma (n = 25), microadenoma (n = 8) or empty sella turcica (n = 3). The mean duration of treatment was 8 years (range 3–18 years). Hormonal and morphological monitoring was undertaken after 6 months, and then the patients were followed annually. RESULTS: After 1 year, the mean GH and IGF-1 levels had reduced considerably (GH: 2·4 ± 0·3 µg/l; IGF-1; 174 ± 14%, P < 0·01), and they continued to decrease over 10 years, with a mean GH level of 1·6 ± 0·1 µg/l and IGF-1 of 123 ± 18% (P = 0·02). GH < 2 µg/l, normal IGF-1, or both were observed in 25 (70%), 24 (67%) and 21 (58%) patients, respectively. The mean reduction in tumour volume was 43% (range 13–97%) and shrinkage > 20% was obtained in 21 patients (72%). SSTa treatment was well tolerated with few digestive or metabolic side-effects. CONCLUSION: Long-term (up to 18 years) treatment with SSTa used as first-line therapy is effective from both an antihormonal and antitumour perspective, and is well tolerated in acromegalic patients.
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spelling pubmed-19748332007-09-10 Long-term (up to 18 years) effects on GH/IGF-1 hypersecretion and tumour size of primary somatostatin analogue (SSTa) therapy in patients with GH-secreting pituitary adenoma responsive to SSTa Maiza, Jean Christophe Vezzosi, Delphine Matta, Maria Donadille, Florence Loubes-Lacroix, Florence Cournot, Maxime Bennet, Antoine Caron, Philippe Clin Endocrinol (Oxf) Original Articles CONTEXT: The role of somatostatin analogues (SSTa) in the treatment of acromegaly. OBJECTIVE: To evaluate the antihormonal and antitumour efficacy of long-term (up to 18 years) primary treatment with SSTa in patients with GH-secreting pituitary adenoma responsive to SSTa. DESIGN: An open, prospective, single-centre, clinical study. PATIENTS: Thirty-six acromegalic patients, aged 17–75 years (postoral glucose tolerance test GH > 1 µg/l, increased IGF-1 for age and sex), were monitored in a single centre and treated with SSTa as first-line therapy. The mean pretreatment GH level was 13·5 ±3·1 µg/l, and IGF-1 (as a percentage of the value over the normal range) was 302 ± 26%. The patients had macroadenoma (n = 25), microadenoma (n = 8) or empty sella turcica (n = 3). The mean duration of treatment was 8 years (range 3–18 years). Hormonal and morphological monitoring was undertaken after 6 months, and then the patients were followed annually. RESULTS: After 1 year, the mean GH and IGF-1 levels had reduced considerably (GH: 2·4 ± 0·3 µg/l; IGF-1; 174 ± 14%, P < 0·01), and they continued to decrease over 10 years, with a mean GH level of 1·6 ± 0·1 µg/l and IGF-1 of 123 ± 18% (P = 0·02). GH < 2 µg/l, normal IGF-1, or both were observed in 25 (70%), 24 (67%) and 21 (58%) patients, respectively. The mean reduction in tumour volume was 43% (range 13–97%) and shrinkage > 20% was obtained in 21 patients (72%). SSTa treatment was well tolerated with few digestive or metabolic side-effects. CONCLUSION: Long-term (up to 18 years) treatment with SSTa used as first-line therapy is effective from both an antihormonal and antitumour perspective, and is well tolerated in acromegalic patients. Blackwell Publishing Ltd 2007-08-01 /pmc/articles/PMC1974833/ /pubmed/17524029 http://dx.doi.org/10.1111/j.1365-2265.2007.02878.x Text en © 2007 The Authors Journal compilation © 2007 Blackwell Publishing Ltd https://creativecommons.org/licenses/by/2.5/ Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2·5, which does not permit commercial exploitation.
spellingShingle Original Articles
Maiza, Jean Christophe
Vezzosi, Delphine
Matta, Maria
Donadille, Florence
Loubes-Lacroix, Florence
Cournot, Maxime
Bennet, Antoine
Caron, Philippe
Long-term (up to 18 years) effects on GH/IGF-1 hypersecretion and tumour size of primary somatostatin analogue (SSTa) therapy in patients with GH-secreting pituitary adenoma responsive to SSTa
title Long-term (up to 18 years) effects on GH/IGF-1 hypersecretion and tumour size of primary somatostatin analogue (SSTa) therapy in patients with GH-secreting pituitary adenoma responsive to SSTa
title_full Long-term (up to 18 years) effects on GH/IGF-1 hypersecretion and tumour size of primary somatostatin analogue (SSTa) therapy in patients with GH-secreting pituitary adenoma responsive to SSTa
title_fullStr Long-term (up to 18 years) effects on GH/IGF-1 hypersecretion and tumour size of primary somatostatin analogue (SSTa) therapy in patients with GH-secreting pituitary adenoma responsive to SSTa
title_full_unstemmed Long-term (up to 18 years) effects on GH/IGF-1 hypersecretion and tumour size of primary somatostatin analogue (SSTa) therapy in patients with GH-secreting pituitary adenoma responsive to SSTa
title_short Long-term (up to 18 years) effects on GH/IGF-1 hypersecretion and tumour size of primary somatostatin analogue (SSTa) therapy in patients with GH-secreting pituitary adenoma responsive to SSTa
title_sort long-term (up to 18 years) effects on gh/igf-1 hypersecretion and tumour size of primary somatostatin analogue (ssta) therapy in patients with gh-secreting pituitary adenoma responsive to ssta
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1974833/
https://www.ncbi.nlm.nih.gov/pubmed/17524029
http://dx.doi.org/10.1111/j.1365-2265.2007.02878.x
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