OCTREOTIDA: UNA ALTERNATIVA MEDICA EFICAZ PARA EL TRATAMIENTO DE LA ACROMEGALIA





OCTREOTIDA: UNA ALTERNATIVA MEDICA EFICAZ PARA EL TRATAMIENTO DE LA ACROMEGALIA

(especial para SIIC © Derechos reservados)
Los nuevos análogos de la somatostaina, con diferentes perfiles de afinidad, podrían representar un abordaje prometedor para el tratamiento clínico de los pacientes con acromegalia.
resmini9.jpg Autor:
Eugenia Resmini
Columnista Experto de SIIC

Institución:
University of Genova


Artículos publicados por Eugenia Resmini
Coautores
Alberto Rebora* Federico Gatto* Francesco Minuto* Diego Ferone* 
University of Genova, Génova, Italia*
Recepción del artículo
16 de Julio, 2007
Aprobación
27 de Septiembre, 2007
Primera edición
9 de Septiembre, 2008
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
Si bien la neurocirugía aún es considerada el tratamiento de primera elección para pacientes con acromegalia, la alta eficacia de los análogos de la somatostatina (AS) en el control de la hipersecreción hormonal y del crecimiento tumoral fomenta su empleo como terapia fundamental en determinados pacientes. El criterio principal para definir la respuesta clínica a los AS está basado en el control bioquímico de la enfermedad. En este artículo describimos el caso de un paciente con acromegalia tratado inicialmente con octreotida LAR (fórmula de liberación prolongada) y en quien el tumor de la glándula hipófisis desapareció luego de 18 meses de tratamiento; éste fue el primer caso de remisión radiológica completa de un tumor hipofisario durante el tratamiento de la acromegalia con octreotida LAR. Sin embargo, los mecanismos de acción de los AS en la inhibición del crecimiento tumoral y de la secreción hormonal no son conocidos en su totalidad, y los dos efectos podrían tener lugar independientemente uno del otro. Recientemente, hemos demostrado un caso de disminución masiva del tamaño del tumor en un paciente que presentaba un escaso control bioquímico de la enfermedad. Tal resultado coincide con la hipótesis que plantea que los efectos antitumorales de la octreotida podrían producirse independientemente de la actividad antihormonal de dicho fármaco.

Palabras clave
acromegalia, análogos de la hormona somatostatina, tratamiento médico primario


Artículo completo

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Abstract
Although neurosurgery is still considered the first line therapy for patients with acromegaly, the high efficacy of somatostatin analogs (SSA) in controlling hormone hypersecretion, as well as tumor growth, encouraged the use of SSA as primary therapy in selected patients. The main criterion to define the clinical response to SSA is based on the biochemical control of the disease. We described the case of an acromegalic patient primarily treated with octreotide LAR in whom the pituitary tumor disappeared after 18 months of treatment, this was the first case of complete radiological remission of pituitary tumor during octreotide LAR treatment in acromegaly. However, the mechanisms of action of SSA in inhibiting tumor growth and hormonal secretion are still not fully understood and the two effects may occur independently by each other. We have recently demonstrated a case of a massive shrinkage in a patient with a poor biochemical control of the disease. This evidence supports the hypothesis that the antitumoral effect of octreotide may occur independently of the antihormonal activity of the drug.

Key words
acromegaly, somatostatin analogs, primary medical therapy


Full text
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Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Endocrinología y Metabolismo
Relacionadas: Farmacología, Neurología, Oncología



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Enviar correspondencia a:
Eugenia Resmini, University of Genova Department of Endocrinology & Metabolic Sciences, 16132, Viale Benedetto XV, 6, Génova, Italia
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