2.50
Hdl Handle:
http://hdl.handle.net/10541/78911
Title:
Medical treatment in acromegaly.
Authors:
Paisley, Angela N; Trainer, Peter J
Abstract:
Acromegaly is a rare disabling disorder that results in premature death. The excess mortality and morbidity are the result of prolonged elevation of growth hormone (GH) and insulin-like growth factor-I (IGF-I) levels, and vigorous control of these improves well-being and restores life expectancy to normal. Recognition of the benefits of treatment has emphasised the need for optimal control of the GH/IGF-I axis. Transsphenoidal surgery is first-line therapy in the majority of patients; however, as most tumours are macroadenomas, cure rates are low. The role of radiotherapy is evolving and, although extremely effective at controlling tumour growth, it can take up to 15 years to control GH & IGF-I levels. In the interim, medical therapy is necessary. Dopamine agonists are inexpensive oral agents but, although most patients experience some benefit, GH and IGF-I levels are only normalised in around 35-40% of patients, and side effects are common. Somatostatin analogues are the gold standard of medical treatment. They can induce tumour shrinkage in a proportion of patients and can normalise the GH/IGF-I axis (at best) in approximately 65% of individuals; however, this leaves a significant cohort uncontrolled. The advent of the GH receptor antagonist pegvisomant provides the potential for IGF-I to be normalised in virtually every patient, but this novel form of therapy, which does not act on the pituitary, also raises many questions.
Affiliation:
Department of Endocrinology, Christie Hospital, Wilmslow Road, Manchester M20 4BX, UK.
Citation:
Medical treatment in acromegaly. 2003, 3 (6):672-7 Curr Opin Pharmacol
Journal:
Current Opinion in Pharmacology
Issue Date:
Dec-2003
URI:
http://hdl.handle.net/10541/78911
DOI:
10.1016/j.coph.2003.07.007
PubMed ID:
14644022
Type:
Article
Language:
en
ISSN:
1471-4892
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorPaisley, Angela N-
dc.contributor.authorTrainer, Peter J-
dc.date.accessioned2009-08-27T14:51:42Z-
dc.date.available2009-08-27T14:51:42Z-
dc.date.issued2003-12-
dc.identifier.citationMedical treatment in acromegaly. 2003, 3 (6):672-7 Curr Opin Pharmacolen
dc.identifier.issn1471-4892-
dc.identifier.pmid14644022-
dc.identifier.doi10.1016/j.coph.2003.07.007-
dc.identifier.urihttp://hdl.handle.net/10541/78911-
dc.description.abstractAcromegaly is a rare disabling disorder that results in premature death. The excess mortality and morbidity are the result of prolonged elevation of growth hormone (GH) and insulin-like growth factor-I (IGF-I) levels, and vigorous control of these improves well-being and restores life expectancy to normal. Recognition of the benefits of treatment has emphasised the need for optimal control of the GH/IGF-I axis. Transsphenoidal surgery is first-line therapy in the majority of patients; however, as most tumours are macroadenomas, cure rates are low. The role of radiotherapy is evolving and, although extremely effective at controlling tumour growth, it can take up to 15 years to control GH & IGF-I levels. In the interim, medical therapy is necessary. Dopamine agonists are inexpensive oral agents but, although most patients experience some benefit, GH and IGF-I levels are only normalised in around 35-40% of patients, and side effects are common. Somatostatin analogues are the gold standard of medical treatment. They can induce tumour shrinkage in a proportion of patients and can normalise the GH/IGF-I axis (at best) in approximately 65% of individuals; however, this leaves a significant cohort uncontrolled. The advent of the GH receptor antagonist pegvisomant provides the potential for IGF-I to be normalised in virtually every patient, but this novel form of therapy, which does not act on the pituitary, also raises many questions.en
dc.language.isoenen
dc.subject.meshAcromegaly-
dc.subject.meshClinical Trials as Topic-
dc.subject.meshDopamine Agonists-
dc.subject.meshHuman Growth Hormone-
dc.subject.meshHumans-
dc.subject.meshInsulin-Like Growth Factor I-
dc.subject.meshReceptors, Somatotropin-
dc.titleMedical treatment in acromegaly.en
dc.typeArticleen
dc.contributor.departmentDepartment of Endocrinology, Christie Hospital, Wilmslow Road, Manchester M20 4BX, UK.en
dc.identifier.journalCurrent Opinion in Pharmacologyen

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