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Results for “ACROMEGALY”

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PubMed1979

Radiogrammetry of the soft tissue at the index finger in acromegaly.

Measurements of the soft-tissue width and phalanx width at the index finger were made in 30 acromegalic patients and compared with values obtained in a large control population. The width of the phalanx, total finger width and soft-tissue thickness are significantly larger than expected and the soft-tissue index values are significantly lower than expected. An important overlap between normal and acromegalic values is found for the soft-tissue index and width of the proximal phalanx. The measurement which best discriminates acromegalics from normal is the total finger width. The soft-tissue thickness parameter is also very sensitive for the detection of acromegalic changes and has the advantage of not being sex and age dependent.

Acromegaly↗
PubMed1996

Sandostatin LAR (microencapsulated octreotide acetate) in acromegaly: pharmacokinetic and pharmacodynamic relationships.

Double-blind, single-dose studies of 120 acromegalic patients given 10, 20, and 30 mg Sandostatin LAR (Sandoz Pharma Ltd, Basel, Switzerland) established the drug's pharmacokinetic profile. Patients then entered open-labeled extension phases, with Sandostatin LAR intramuscular (IM) injections every 4 weeks. These produced broadly constant octreotide concentrations with dose proportionality. Area fluctuations were minimal. Steady-state conditions were generally reached after the second to third injection. There was no evidence of downregulation with Sandostatin LAR over 1 year of study. Based on the pharmacokinetic/pharmacodynamic relationship of octreotide, a starting dose of 20 mg Sandostatin LAR and administrations every 4 weeks provide growth hormone (GH) control comparable to the thrice-daily subcutaneous (SC) injection regimen, which is commonly 0.3 to 0.6 mg/d. The reduction from the burden of two to three SC injections per day is a particular advantage of Sandostatin LAR, which is an attractive alternative to the approved Sandostatin injection.

Acromegaly↗
PubMed1996

Metabolic aspects of acromegaly and its treatment.

Growth hormone (GH) affects virtually all facets of metabolism. This review concentrates on the effects of GH excess on carbohydrate, lipid, and bone metabolism, and on body composition. The effect of treatment with the somatostatin analog, octreotide, on the gastrointestinal-pancreatic axis is also discussed.

Acromegaly↗
PubMed1996

Presurgical Octreotide: treatment in acromegaly.

One hundred seventy-two acromegalics who were operated on using the trans-sphenoidal approach underwent long-term follow-up evaluation. Sixty-four received 100 micrograms octreotide subcutaneously three times daily: for 3 to 6 weeks before surgery in 14 patients (group 1); and for 3 to 9 months in 41 and for 13 to 39 months in nine (n = 50, group 2). In 18 group 2 patients, the dose was increased stepwise to 500 micrograms three times daily because of incomplete suppression of growth hormone (GH)/insulin-like growth factor-1 (IGF-1). Tumor shrinkage was seen in 60% within 3 weeks, being nearly maximal by 3 to 4 months. More group 2 patients had greater than 25% tumor shrinkage (14 of 48 v 1 of 14 in group 1). Clinical response was excellent or good in 89%. Decrease in soft-tissue swelling and weight loss, and improved vitality, performance, carbohydrate metabolism, and cardiovascular function, facilitated anesthetic and surgical management; tumor removal was easy in virtually all cases. In all 64 patients, GH levels decreased by > or = 50%, and to < 2 micrograms/L in three of 14 patients initially and 25 of 50 patients after more prolonged treatment. IGF-1 levels decreased to normal in seven of 14 group 1 and 31 of 50 group 2 patients. Light and electron microscopy showed that adenomatous tissue exposed to octreotide had lysosomal accumulation, amyloid deposition, mild to moderate perivascular fibrosis, and moderate size reduction in both cytoplasmic and nuclear areas, with virtually no cellular complications. Remission with enclosed adenomas was greater (p < .05) than for the 108 patients not treated with octreotide; there was no difference for invasive adenomas. Octreotide use for 3 to 4 months before surgery can be recommended.

Acromegaly↗
PubMed1996

Long-term effects of radiotherapy for acromegaly.

Radiotherapy is a largely safe procedure and if carefully carried out, has few side effects. It is most frequently indicated after unsuccessful or incompletely successful surgery. Often in these circumstances, growth hormone levels are significantly reduced by surgery, although not to normal. Radiotherapy can work more quickly if growth hormone levels have been reduced to less than 50 mU/L. The beneficial effects of radiotherapy on growth hormone secretion continue for more than 10 years after its administration.

Acromegaly↗

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