A utilização da octreotida subcutânea ou LAR como teste preditivo e no tratamento da acromegalia

Halah, Fernanda P. B.; Elias, Lucila Leico Kagohara; Martinelli, Carlos Eduardo; Castro, Margaret; Moreira, Ayrton Custódio

doi:10.1590/s0004-27302004000200007

Cited by 11 publications

(2 citation statements)

References 34 publications

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“…Therefore, the ability to predict which patients will achieve "safe" GH levels and IGF-I normalization would be advantageous. The usefulness of the acute test with subcutaneous octreotide has been extensively investigated (56)(57)(58)(59)(60)(61)(62)(63) and even intravenous octreotide has been used for this purpose (64). A positive response is considered when GH levels fall at least 50%.…”

Section: Defining the Treatment Of Acromegalymentioning

confidence: 99%

Etiologic aspects and management of acromegaly

Taboada

Haute

Corrêa

et al. 2005

Arq Bras Endocrinol Metab

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Acromegaly is a systemic disease with various etiologies. It can occur as a sporadic or, more rarely, as a familial disease. Numerous complications such as endocrine, cardiovascular, respiratory, metabolic, osteoarticular and neoplastic disturbances occur and must be taken into account when establishing a therapeutic strategy. For this reason, the decision as to a treatment modality of acromegaly must be followed by a thorough evaluation of the patient and once the diagnosis of complications is settled, adequate treatment should be instituted. Follow up of the patients requires periodical re-assessment of complications status.

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Section: Defining the Treatment Of Acromegalymentioning

confidence: 99%

Etiologic aspects and management of acromegaly

Taboada

Haute

Corrêa

et al. 2005

Arq Bras Endocrinol Metab

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“…Assim, a capacidade de prever quais os pacientes responsivos a esta modalidade terapêutica seria útil na escolha do tratamento. O teste agudo com a administração subcutânea de octreotide, considerando-se resposta positiva a redução de 50% dos níveis de GH, já foi descrito como preditor da resposta à terapia com esta medicação (22)(23)(24)(25)(26). No entanto, outros autores contestam a sua utilização com esta finalidade, sugerindo que os resultados do tratamento após 1-6 meses seriam melhores preditores da resposta a longo prazo (20,27).…”

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Teste agudo com octreotide subcutâneo como preditor de resposta ao tratamento com octreotide LAR®

Taboada

Donangelo

Guimarães

et al. 2005

Arq Bras Endocrinol Metab

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RESUMOOs análogos da somatostatina são muito utilizados no tratamento da acromegalia. Com o objetivo de determinar o valor do teste agudo (TA) com octreotide subcutâneo (SC) como preditor da resposta ao tratamento com octreotide LAR ® , analisamos os dados de 20 pacientes. Para o TA, amostras de sangue foram colhidas antes e duas horas após a administração de octreotide SC para a dosagem de GH. Os níveis de GH antes e após o TA foram 21,9 (2,3-143,4) e 3,1ng/mL (0,3-61,3), respectivamente. Foi considerado controle de doença: GH< 2,5ng/mL e IGF-I normal em algum momento durante o tratamento. A sensibilidade, especificidade e os valores preditivos positivo e negativo do TA foram 0,9, 0,6, 0,69 e 0,86 para redução de 75% do GH no teste. Concluímos que, em nossa casuística, um decréscimo de 75% dos níveis de GH no TA teve um bom poder discriminatório entre pacientes com maior e menor chance de resposta ao tratamento. ABSTRACT Acute Test With Subcutaneous Octreotide as a Predictor of the Response to Treatment With Octreotide LAR ® .Somatostatin analogues are frequently used to treat acromegaly. To determine the value of the acute test (AT) with subcutaneous (SC) octreotide as a predictor of the response to treatment with octreotide LAR ® , we analyzed data from 20 patients. For the AT, blood was drawn before and two hours after the SC administration of octreotide for measuring GH. GH levels before and after the AT were 21.9ng/mL (2.3-143.4) and 3.1ng/mL (0.3-61.3), respectively. Control of the disease was defined as: GH< 2.5ng/mL and normal IGF-I anytime during treatment. Sensitivity, specificity, positive and negative predictive values of the AT were 0.9, 0.6, 0.69 and 0.86 for a reduction of 75% of the GH on the test. From our sample we conclude that a 75% reduction of the GH levels during the acute test was able to discriminate patients with a higher or lower chance of responding to treatment.

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