Medical Therapy for Acromegaly

Newman, Connie B.

doi:10.1016/s0889-8529(05)70062-1

Cited by 74 publications

(42 citation statements)

References 108 publications

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“…It seems to be of comparable efficacy and of good tolerability [6]. While short-acting octreotide has to be administered several times a day, the long-acting formulation needs to be injected only once every 2-4 weeks [7]. Thus, octreotide LAR provides a considerable improvement in convenience for the patient.…”

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confidence: 99%

Normal Delivery Following an Uneventful Pregnancy in a Japanese Acromegalic Patient after Discontinuation of Octreotide Long Acting Release Formulation at an Early Phase of Pregnancy

et al. 2006

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Abstract. We report a 35-year-old woman with active acromegaly despite pituitary surgery and irradiation who received continuous octreotide LAR treatment for the control of GH excess until discovery of her pregnancy. The patient delivered a healthy boy following an uneventful pregnancy after discontinuing octreotide LAR as soon as possible at the early phase of pregnancy. Despite a substantial maternal-fetal transfer of octreotide, postnatal development was normal at 3 years of age. In almost all previously described cases, octreotide was discontinued after pregnancy was confirmed. No side-effects of mother or fetus have been reported. Octreotide treatment in pregnancy seems to be feasible and safe. Due to the stilllimited number of reported cases treated with octreotide LAR, the potential benefits of octreotide LAR treatment should be weighed carefully against its possible risks.

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confidence: 99%

Normal Delivery Following an Uneventful Pregnancy in a Japanese Acromegalic Patient after Discontinuation of Octreotide Long Acting Release Formulation at an Early Phase of Pregnancy

et al. 2006

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“…Dopamine agonists lower GH levels by 10%. 1,31,37 Once radiosurgery is planned, Landolt and Lomax 18 recommend stopping medical therapy 2 weeks prior to radiosurgery. As discussued in the Prolactin-Secreting Ade-nomas section, they hypothesize that medical therapy lowers the metabolic rate of the tumor, rendering it less susceptible to radiosurgery.…”

Section: Acromegalymentioning

confidence: 99%

Radiation therapy in the treatment of pituitary tumors

Ghostine

Johnson³

2008

FOC

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✓ The treatment of pituitary tumors has progressed into a multidisciplinary approach that involves neurosurgeons, radiation oncologists, and endocrinologists. This has allowed improved outcomes in treatment of pituitary tumors due to a combination of surgical, medical, and radiation therapies. In this study, the authors review the role of radiation therapy in the treatment of pituitary adenomas.

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“…Na maioria das vezes a redução é leve a moderada, entre 20 e 50%, portanto não deve-se esperar que ocorra redução tumoral que descomprima o quiasma óptico nos pacientes com comprometimento visual (49). Esta medicação se mostrou segura para uso prolongado, por um tempo de uso de 6 a 41 meses entre os vários estudos (57,(68)(69)(70). Os pacientes com adenomas hipofisários invasivos com pequena chance de cura cirúrgica, que não causam comprometimento neurológico ou visual, e com risco cirúrgico elevado pelas co-morbidades clínicas, parecem ser candidatos ideais à terapia medicamentosa primária (figura 1) (49).…”

Section: -Análogos De Somatostatinaunclassified

“…Alterações gastrointestinais (diarréia, náuseas, desconforto abdominal) são queixas em cerca da metade dos pacientes, mas na grande maioria das vezes são transitórias e de intensidade leve a moderada (42,49). Em cerca de 25% dos pacientes que usam octreotide subcutâneo (43,70) e em 15% dos que usam a forma depot (49), encontra-se formação de cálculos ou de lama biliar. Via de regra, a colelitíase é assintomática e sem correlação com a dose do medicamento.…”

Section: -Análogos De Somatostatinaunclassified

Diagnóstico e tratamento da acromegalia no Brasil

Donangelo

Une

Gadelha

2003

Arq Bras Endocrinol Metab

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RESUMOAcromegalia é uma doença debilitante e desfigurante que, se não controlada adequadamente, reduz a expectativa de vida do paciente.Complicações cardiovasculares e respiratórias representam as principais causas de morte nos acromegálicos. Atualmente, o diagnóstico é realizado de acordo com as diretrizes do consenso de 2000: ausência de supressão do GH para um valor <1ng/mL e IGF-1 elevado. Avanços em todas as modalidades terapêuticas têm ocorrido, propiciando o controle bioquímico da doença em um número cada vez maior de pacientes. Estudos prévios mostraram que a obtenção de níveis seguros de GH (GH médio <2,5ng/mL) e de IGF-1 normal reduz a taxa de mortalidade para o normal. Em 2002, foram publicadas diretrizes para o manejo da acromegalia, o qual envolve, muitas vezes, uma abordagem multidisciplinar. Neste artigo, fazemos uma avaliação crítica do que dispomos no Brasil para seguirmos as diretrizes estabelecidas nos consensos sobre diagnóstico e tratamento da acromegalia. ABSTRACT Diagnosis and Treatment of Acromegaly in Brazil.Acromegaly is a disabling and disfiguring illness, which, if not adequately controlled, decreases life expectancy. Cardiovascular and respiratory complications represent the main causes of death in acromegalic patients. Nowadays, the diagnosis is made following the guidelines reported in the 2000 consensus: Failure of GH to suppress to less than 1ng/mL and an increased IGF-1. Progress in all therapeutic modalities has been made, allowing biochemical disease control in more patients. Previous studies demonstrated that achieving safe GH levels (mean GH <2.5ng/mL) and normal IGF-1 decreases mortality rate to normal. In 2002, the guidelines for management of acromegaly were published which encompass, many times, a multidisciplinary approach. In this article, we critically evaluate what is available in Brazil that allows us to follow the guidelines established in the diagnosis and treatment consensus.

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Medical Therapy for Acromegaly

Cited by 74 publications

References 108 publications

Normal Delivery Following an Uneventful Pregnancy in a Japanese Acromegalic Patient after Discontinuation of Octreotide Long Acting Release Formulation at an Early Phase of Pregnancy

Normal Delivery Following an Uneventful Pregnancy in a Japanese Acromegalic Patient after Discontinuation of Octreotide Long Acting Release Formulation at an Early Phase of Pregnancy

Radiation therapy in the treatment of pituitary tumors

Diagnóstico e tratamento da acromegalia no Brasil

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