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Pituitary

Erschienen in:

07.02.2017

Somatostatin receptor ligands in the treatment of acromegaly

verfasst von: Monica R. Gadelha, Luiz Eduardo Wildemberg, Marcello D. Bronstein, Federico Gatto, Diego Ferone

Erschienen in: Pituitary | Ausgabe 1/2017

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Abstract

First-generation somatostatin receptors ligands (SRL) are the mainstay in the medical treatment of acromegaly, however the percentage of patients controlled with these drugs significantly varies in the different studies. Many factors are involved in the resistance to SRL. In this review, we update the physiology of somatostatin and its receptors (sst), the use of SRL in the treatment of acromegaly and the factors involved in the response to these drugs. The SRL act through interaction with the sst, which up to now have been characterized as five subtypes. The first-generation SRL, octreotide and lanreotide, are considered sst2 specific and have biochemical response rates varying from 20 to 70%. Tumor volume reduction can be found in 36–75% of patients. Several factors may determine the response to these drugs, such as sst, AIP, E-cadherin, ZAC1, filamin A and β-arrestin expression in the somatotropinomas. In patients resistant to first-generation SRL, alternative medical treatment options include: SRL high dose regimens, SRL in combination with cabergoline or pegvisomant, or the use of pasireotide. Pasireotide is a next-generation SRL with a broader pattern of interaction with sst. In the light of the recent increase of treatment options in acromegaly and the deeper knowledge of the determinants of response to the current first-line therapy, a shift from a trial-and-error treatment to a personalized one could be possible.

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Titel: Somatostatin receptor ligands in the treatment of acromegaly
verfasst von: Monica R. Gadelha
Luiz Eduardo Wildemberg
Marcello D. Bronstein
Federico Gatto
Diego Ferone
Publikationsdatum: 07.02.2017
Verlag: Springer US
Erschienen in: Pituitary / Ausgabe 1/2017
Print ISSN: 1386-341X
Elektronische ISSN: 1573-7403
DOI: https://doi.org/10.1007/s11102-017-0791-0

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Somatostatin receptor ligands in the treatment of acromegaly

Abstract

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Sind Betablocker auch für ältere herzschwache Personen nützlich?

Kein Abstrich bei chronischen Wunden ohne Entzündungszeichen!

Manche Gestagene können das Risiko für Meningeome erhöhen

Update Innere Medizin

Springer Medizin

Abstract

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Weitere Artikel der Ausgabe 1/2017

Acromegaly: clinical features at diagnosis

Acromegaly, a pituitary special issue

Somatostatin and dopamine receptor regulation of pituitary somatotroph adenomas

Biochemical investigations in diagnosis and follow up of acromegaly

The genetic background of acromegaly

Cabergoline in acromegaly

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Sind Betablocker auch für ältere herzschwache Personen nützlich?

Kein Abstrich bei chronischen Wunden ohne Entzündungszeichen!

Manche Gestagene können das Risiko für Meningeome erhöhen

Update Innere Medizin