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Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
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The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Direct-acting cholinergic agonists have many therapeutic uses in various medical fields. Choline esters, including acetylcholine, have limited clinical utility due to their non-selectivity and short duration of action. Still, acetylcholine and carbachol are applied topically during ophthalmologic surgery to induce miosis. Pilocarpine, a muscarinic and ganglionic stimulator, effectively treats open-angle glaucoma and alleviates xerostomia and dry mouth caused by radiotherapy or Sjögren...
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Safety and Efficacy of Once-Daily Oral Paltusotine in Acromegaly: ACROBAT Advance Open-Label Extension Up to 4 Years.

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Reassuring long-term data on efficacy and safety of pegvisomant monotherapy in a large series of patients with acromegaly.

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Innovative therapeutics in acromegaly.

Leandro Kasuki1, Mônica R Gadelha2

  • 1Neuroendocrinology Research Center/Endocrinology Division, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil; Neuroendocrinology Division, Instituto Estadual Do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde, Rio de Janeiro, Brazil; Endocrinology Division, Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil.

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Acromegaly treatment innovations are needed as current methods often fail. This review explores recent advances and future directions for better acromegaly disease control.

Keywords:
acromegalymedical treatmentnovel treatmentsprecision medicinesomatostatin receptor ligands

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Area of Science:

  • Endocrinology
  • Internal Medicine
  • Pharmacology

Background:

  • Acromegaly is a serious systemic disease linked to higher morbidity and mortality.
  • Effective disease control is crucial for preventing complications.
  • Current treatments (surgery, medication, radiotherapy) do not achieve sustained remission in all patients.

Purpose of the Study:

  • To review recent innovations in acromegaly treatment.
  • To discuss future perspectives for managing acromegaly.
  • To highlight the need for improved therapeutic strategies beyond the current trial-and-error approach.

Main Methods:

  • Literature review of recent studies on acromegaly treatment.
  • Analysis of current therapeutic modalities and their limitations.
  • Exploration of emerging drug development and treatment strategies.

Main Results:

  • Despite available treatments, a significant number of acromegaly patients exhibit persistent disease activity.
  • Recent innovations focus on targeted therapies and personalized treatment approaches.
  • New pharmacological agents are under development to improve efficacy and safety.

Conclusions:

  • There is a clear need for novel therapeutic strategies in acromegaly management.
  • Innovations aim to move beyond the current trial-and-error paradigm.
  • Future perspectives include the development of new drugs and refined treatment protocols for better disease control.