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Titolo:
Evaluation of the treatment of thyrotropin-secreting pituitary adenomas with a slow release formulation of the somatostatin analog lanreotide
Autore:
Kuhn, JM; Arlot, S; Lefebvre, H; Caron, P; Cortet-Rudelli, C; Archambaud, F; Chanson, P; Tabarin, A; Goth, MI; Blumberg, J; Catus, F; Ispas, S; Beck-Peccoz, P;
Indirizzi:
Univ Hosp, Dept Endocrinol, F-76031 Rouen, France Univ Hosp Rouen FranceF-76031 p, Dept Endocrinol, F-76031 Rouen, France Dept Endocrinol, F-80054 Amiens, France Dept Endocrinol Amiens France F-80054 Endocrinol, F-80054 Amiens, France Dept Endocrinol, F-31403 Toulouse, France Dept Endocrinol Toulouse France F-31403 crinol, F-31403 Toulouse, France Dept Endocrinol, F-59037 Lille, France Dept Endocrinol Lille France F-59037 t Endocrinol, F-59037 Lille, France Dept Endocrinol, F-87042 Limoges, France Dept Endocrinol Limoges France F-87042 docrinol, F-87042 Limoges, France Dept Endocrinol, F-94275 Paris, France Dept Endocrinol Paris France F-94275 t Endocrinol, F-94275 Paris, France Dept Endocrinol, F-33604 Bordeaux, France Dept Endocrinol Bordeaux France F-33604 crinol, F-33604 Bordeaux, France Univ Hosp, H-1389 Budapest, Hungary Univ Hosp Budapest Hungary H-1389Univ Hosp, H-1389 Budapest, Hungary Univ Hosp, Dept Endocrinol, H-1389 Budapest, Hungary Univ Hosp Budapest Hungary H-1389 t Endocrinol, H-1389 Budapest, Hungary Univ Hosp, Dept Endocrinol, I-20089 Milan, Italy Univ Hosp Milan Italy I-20089 osp, Dept Endocrinol, I-20089 Milan, Italy Ipsen Biotech Labs, F-75016 Paris, France Ipsen Biotech Labs Paris France F-75016 tech Labs, F-75016 Paris, France Univ Rouen, INSERM, U413, IFR Peptides, F-76130 Mt St Aignan, France Univ Rouen Mt St Aignan France F-76130 des, F-76130 Mt St Aignan, France
Titolo Testata:
JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM
fascicolo: 4, volume: 85, anno: 2000,
pagine: 1487 - 1491
SICI:
0021-972X(200004)85:4<1487:EOTTOT>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
LONG-ACTING FORMULATION; ACROMEGALIC PATIENTS; SMS 201-995; FOLLOW-UP; TERM TREATMENT; NORMAL MEN; SANDOSTATIN-LAR; GROWTH-HORMONE; OCTREOTIDE; SMS-201-995;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
42
Recensione:
Indirizzi per estratti:
Indirizzo: Kuhn, JM Hop Bois Guillaume, Dept Endocrinol, 147 Ave Marechal Juin, F-76230 Bois Guillaume, France Hop Bois Guillaume 147 Ave Marechal Juin Bois Guillaume France F-76230
Citazione:
J.M. Kuhn et al., "Evaluation of the treatment of thyrotropin-secreting pituitary adenomas with a slow release formulation of the somatostatin analog lanreotide", J CLIN END, 85(4), 2000, pp. 1487-1491

Abstract

Somatostatin analogs have been shown to be effective for the treatment of TSH-secreting pituitary adenomas. However, their use in this indication is limited by the fact that available analogs require several daily sc injections. The present study was performed to evaluate the effects of a slow release formulation of the somatostatin analog lanreotide (SR-L) on both hormone secretion and tumor size and to assess the tolerance in a series of thyrotropinomas treated for 6 months. Eighteen patients with hyperthyroidism related to a TSH-secreting pituitary adenoma, evidenced by pituitary magnetic resonance imaging, were studied. After a basal assessment, each patient received 30 mg SR-L, im, every 14 days for 1 month. Then, according to the free T-3 (fT(3)) plasma level measured, 9 of 18 patients were injected twice monthly, and 7 of 18 patients received SR-L every 10 days for 5 additional months. One patient was dismissed from the study in month 1 of the study forside-effects and another in month 3 for noncompliance to the protocol. Clinical and biological evaluations (plasma TSH, free alpha-subunit, fT(4), fT(3), and lanreotide levels) were performed before and in months 1, 3, and 6of treatment. Pituitary magnetic resonance imaging and gallbladder ultrasonography were performed both at entry and at the end of the study. Clinicalsigns of hyperthyroidism improved within 1 month in all 16 evaluable patients. Mean (+/- SEM) plasma lanreotide levels reached 1.11 +/- 0.43 and 1.69+/- 0.65 ng/mL in month 3 using 2 and 3 injections/month, respectively, then remained stable until the end of the study. During therapy, the plasma TSH level decreased from 2.72 +/- 0.32 to 1.89 +/- 0.27 mU/L (P < 0.01), with parallel significant changes in free ar-subunit. During the same period, plasma fT(4) and fT(3) levels decreased from 37.9 +/- 2.9 to 19.7 +/- 2.5 pmol/L (P < 0.01) and from 14.6 +/- 1.1 to 8.3 +/- 0.8 pmol/L (P < 0.01), respectively. No statistically significant change in mean adenoma size was observed after 6 months of treatment. Side-effects, including pain at the injection point, abdominal cramps, and diarrhea, were mild and transient and did not lead to intenuption of the treatment. No gallstones occurred during the study. SR-L appears to be able to suppress clinical signs of hyperthyroidism in our series of patients with TSH-secreting pituitary adenomas. The analog also reduces plasma TSH and thyroid hormone levels, which were normalized in 13 of 16 cases. The effect was maintained throughout the treatmentusing 2 or 3 SR-L injections: monthly without any problem of tolerance. Weconclude that SR-L is a safe and effective treatment of thyrotropinomas and avoids the drawbacks of the modes of administration of other somatostatinanalogs, given three times daily.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/12/20 alle ore 21:28:34