• The discovery of leptin: The discovery of leptin has changed the perception of fat as a mere glob of unwanted tissue to an understanding of it as hormonally active tissue that affects body weight, fat distribution, pubertal development, and aberrancy in lipid and glucose metabolism. This knowledge is effectively used in the treatment of lipodystrophy.
• Introduction of TKIs in the management of advanced thyroid cancers, including medullary thyroid cancer: The discovery of particular genetic abnormalities in thyroid cancers revealed specific targets for therapy. Activating mutations of the RET tyrosine kinase receptor in thyroid cancer serves as a good model for the use of small organic molecule TKIs for treatment of metastatic disease.
• Diabetes medications and monitoring: Diabetes care has undergone a sea change with a newly flowing pipeline of better drugs, new delivery systems (think insulin pump), and continuous glucose monitoring. This has helped make complications (eg, ophthalmologic problems and foot amputation) much rarer.
• Introduction of wide-spectrum SSRAs in the management of resistant pituitary tumors: Pasireotide (Signifor®) is now approved for treatment of patients with Cushing disease and patients with acromegaly. This drug targets multiple isoforms of somatostatin receptor, particularly impressively with subtype 5.
• Introduction of parathyroid hormone to treat hypoparathyroidism: Parathyroid hormone is now commercially available to treat patients with chronic unstable hypocalcemia.
Top endocrinology advances selected by Romesh Khardori, MD, PhD, Professor of Endocrinology; Director of Training Program, Division of Endocrinology, Diabetes and Metabolism, Strelitz Diabetes and Endocrine Disorders Institute; Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, Virginia.
For more on advances in diabetes medications and monitoring, read here.
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Cite this: What Do You Consider to Be the Top Medical Advances of the Past 20 Years? - Medscape - May 27, 2015.