Navegando por Palavras-chave "Octreotide"
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- ItemAcesso aberto (Open Access)Acarbose promotes remission of both early and late dumping syndromes in post-bariatric patients(Czech Acad Sci, Inst Entomology, 2016) Cadegiani, Flavio A. [UNIFESP]; Silva, Osvalmir SaObjective: Acarbose is a glucosidase inhibitor that slows carbohydrate digestion. It could thus be effective to promote remission of dumping syndrome (DS). Previous studies associating acarbose and late dumping, although not early dumping, have been reported. Herein, we aimed to evaluate the role of acarbose in dumping syndrome prevention and treatment and in resistive exercises resistance in bariatric subjects. Methods: Bariatric patients with DS and complete adherence to diet plan and resistive exercises were included (n=25). Number of early and late episodes, self-referred intensity of each episode, and ability to increase intensity of resistive exercise were evaluated, on a 0-10 scale. Acarbose was administered orally (50 mg) for 6 months, 4-5 times a day before meals. Results: Acarbose administration was associated with a decrease in the number of early (2.18-0.31) and late (2.79-0.12) episodes per week and intensity of each episode (6.10-1.65) and an increase in the ability to perform resistive exercises (3.03-7.12). Complete remission of DS was seen in 21 patients (84%), which persisted for 6 months with the use of acarbose. Conclusion: Acarbose prevented dumping in almost all studied subjects and helped improve exercise capacity.
- ItemAcesso aberto (Open Access)Cost-effectiveness analysis of somatostatin analogues in the treatment of acromegaly in Brazil(Sociedade Brasileira de Endocrinologia e Metabologia, 2008-12-01) Valentim, Joice; Passos, Vanessa; Mataveli, Fabio [UNIFESP]; Calabró, Alessandra; Universidade de São Paulo (USP); Novartis Pharmaceuticals; Universidade Federal de São Paulo (UNIFESP); Novartis Biociências S.A.This study aims to compare economic and patient impacts of the treatment of acromegaly with two different somatostatin analogues (octreotide LAR and lanreotide SR) in Brazil. A cost-effectiveness analysis was carried out under the Brazilian Public Health Care System (SUS) perspective. A decision analytical model was developed based on the Brazilian Public Health Care System Clinical Guideline for Acromegaly. A hypothetical cohort of 276 patients was followed for two years. Data were extracted from literature and administrative databases. Based on the analytical model, treatment with octreotide LAR would avoid 12 and 17 cases of GH and IGF-I elevated serum levels, respectively. Octreotide LAR was a cost-saving strategy, with net savings of R$10,448,324 (US$4,465,096) to SUS. Annual net savings per patient were R$ 18,928 (US$8,089). Treatment of acromegaly with octreotide LAR is a dominant strategy when compared to the treatment with lanreotide SR in Brazil. Sensitivity analysis did not alter the cost-saving status.
- ItemSomente MetadadadosLong-Term Remission of Acromegaly after Octreotide Withdrawal Is an Uncommon and Frequently Unsustainable Event(Karger, 2017) Casagrande, Alessandra [UNIFESP]; Bronstein, Marcello Delano [UNIFESP]; Jallad, Raquel Soares [UNIFESP]; Moraes, Aline B.; Elias, Paula C. L.; Castro, Margaret; Czepielewski, Mauro A.; Boschi, Artur; Ribeiro-Oliveira, Antonio, Jr.; Schweizer, Junia R. O. L.; Vilar, Lucio; Nazato, Debora Maria [UNIFESP]; Gadelha, Monica R.; Abucham, Julio [UNIFESP]Background: Long-term remission of acromegaly after somatostatin analog withdrawal has been reported in 18-42% of patients in studies with a relatively small number of patients using different inclusion and remission criteria. The objectives of this study were to establish the probability and predictive factors for short-and long-term remission [normal IGF-1 for age/sex: IGF-1 x upper limit of normal (ULN)] after octreotide long-acting release (LAR) withdrawal in a larger population of well-controlled patients with acromegaly (normal mean IGF-1 in the last 24 months). Methods: This is a prospective multicenter study in which 58 well-controlled patients with acromegaly receiving only octreotide LAR as a primary or postsurgical treatment were included in 14 university centers in Brazil. All patients had been on stable doses and dose intervals of octreotide LAR in the last year, and none had been submitted to radiotherapy. The main outcome measure was serum IGF-1 after 8 weeks (shortterm) and 60 weeks (long-term) of octreotide LAR withdrawal. Results: Seventeen of 58 patients (29%) were in remission in the short term, and only 4 patients achieved long-term remission after treatment withdrawal. The Kaplan-Meier estimated remission probability at 60 weeks was 7% and decreased to 5% at 72 weeks. The short-term remission rate was significantly higher (44%
- ItemSomente MetadadadosRemission of acromegaly after treatment withdrawal in patients controlled by cabergoline alone or in combination with octreotide: results from a multicenter study(Springer, 2017) Casagrande, A. [UNIFESP]; Bronstein, M. D.; Jallad, R. S.; Mota, J. I.; Tabet, A.; Abucham, J. [UNIFESP]Purpose Remission of acromegaly has been reported after somatostatin analogs withdrawal, but not after withdrawal of combination therapy with cabergoline, and only in case reports of patients controlled by cabergoline alone. Methods To establish the remission rates (normal IGF-1 for age/sex: IGF-1 <= 1.00 xULN) after withdrawal of combined treatment with octreotide LAR and cabergoline and of cabergoline alone, we prospectively studied 16 patients with acromegaly controlled by those treatments in the preceding 2 years as part of a larger study on remission of acromegaly after withdrawal of different medical treatments. Results Among 97 patients with controlled acromegaly included in the entire study, only 16 patients had been on combination therapy (n = 12) or cabergoline alone (n = 4). At 8 weeks after treatment withdrawal, three patients (19%) were in remission (short-term remission). At 60 weeks (long-term remission), IGF-1 levels were still in the normal range in two patients (12.5%) and remained normal up to 108 weeks after treatment withdrawal (last visit). One patient had been treated with cabergoline alone and another one with combination of octreotide and cabergoline before treatment withdrawal. Conclusion Remission of acromegaly after treatment withdrawal seems to be uncommon in patients controlled by cabergoline, either as monotherapy or in combination with octreotide. In the future, larger studies and/or meta-analysis will be necessary to accurately establish the remission rates of acromegaly after withdrawal of cabergoline with or without somatostatin analogs.