Sosa E, Espinosade-los-Monteros AL, González B, Vargas G, Mier F, Mercado M

Idioma: Español
Referencias bibliográficas: 29
Paginas: 651-658
Archivo PDF: 126.39 Kb.

RESUMEN

Introducción: si bien altamente eficaz, el tratamiento de la acromegalia con análogos de somatostatina tiene las desventajas de ser costoso, no curativo y que debe administrarse indefinidamente. Describimos la experiencia de nuestro centro en el tratamiento de la acromegalia con una dosis fija de 20 mg de octreotida LAR cada cuatro semanas.
Material y métodos: 97 pacientes, 71 con macroadenoma, tratados con 20 mg de octreotida LAR intramuscular cada cuatro semanas, en 23 de ellos como tratamiento primario. Se midió GH e IGF-1 a las cuatro semanas después de la tercera inyección y a partir de ese momento las evaluaciones ocurrieron a intervalos de tres a seis meses. En 27 pacientes no seleccionados se realizó una evaluación seis semanas después de la inyección del análogo de somatostatina.
Resultados: se consiguió una concentración de GH ‹ 2.5 ng/mL en 71, 75 y 83 % de los pacientes al tercer, sexto y duodécimo mes de seguimiento, respectivamente, mientras que 34, 38 y 32 % consiguieron normalizar el IGF-1. Ambas metas se lograron en 30, 33 y 32% al tercer, sexto y duodécimo mes, respectivamente. La tasa de éxito bioquímico fue la misma tanto para los pacientes con tratamiento médico primario como para los tratados de manera secundaria. Una concentración de GH ‹ 10 ng/mL se asoció con mala respuesta al tratamiento.
Conclusiones: con la dosis fija de 20 mg de octreótido LAR cada 28 días es posible lograr una tasa de control bioquímico comparable a la de otras series publicadas.

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