Endocrine Abstracts

Pasireotide (Pas) is a multireceptor-targeted somatostatin analogue approved for the treatment of patients with Cushing’s Disease (CD) who fail or are poor candidates to surgery. Pas markedly improves signs and symptoms of the disease, reduces urinary free cortisol (UFC) up to its normalization in 55% of patients and pituitary tumour size in up to 100%. Here we present a patient with severe recurrent CD treated with Pas and showing opposite results between hormonal levels...

Steroids are still widely prescribed in pituitary trans-sphenoidal surgery (TSA). Pituitary-adrenal/thyroid/gonadal functions were prospectively evaluated in 72 consecutive NFPA pts (20–87 years, 37 M) before and after endoscopic-TSA (E-TSA) (63 at first operation, 9 at re-operation). All had macroadenoma with suprasellar extension: impinging optic chiasma in 28, extending into cavernous sinus (CS) in 23, giant in 12. Hydrocortisone was infused peri-operatively only in pt...

Patients: Nineteen acromegalic patients (8 females, 21-69 years-old, with macroadenoma, microadenoma or no evidence of pituitary tumor in 15, 2, 2, respectively) resistant to first generation somatostatin analogs (FG-SA) at high doses and/or intolerant to pegvisomant were switched to pasireotide LAR (PasLAR). Eleven had persistent disease after neurosurgery and two had also undergone radiosurgery (12 and 24 months before starting PasLAR). Six complained of acromegalic headache...

Background: Pasireotide is a multi-ligand somatostatin analogue licensed in a long-acting release formulation (PAS-LAR) for the treatment of acromegaly. The real-life reports with PAS-LAR are still scanty.Objectives: To assess the efficacy and safety of PAS-LAR in patients with acromegaly.Patients and methods: Prospective observational multi-centre study enrolling acromegalics evaluated before (baseline) and 1, 6, 12, 24, and 36 mo...

Introduction: Basal calcitonin (bCT) and calcium-stimulated calcitonin (sCT) levels are useful in the management of Medullary Thyroid Cancer (MTC). Nowadays several bCT/sCT cut-offs have been proposed but univocally accepted values are still lacking. We identified gender-specific CT cut-offs in a series of patients who performed calcium gluconate test at our Centre.Methods: Our study includes a total of 35 patients (12 males and 23 females) with thyroid ...

Introduction: Dopamine agonists are the first line treatment for prolactinomas. However, some patients may develop dopamine-agonist-resistant hyperprolactinemia, leading to surgery and/or radiotherapy. The persistence of hypogonadism requires testosterone replacement therapy which could theoretically reduce the efficacy of dopamine agonists due to the conversion of testosterone to estradiol, thus, in turn, increasing the resistance to dopamine agonists. Consequently, in these ...

COVID-19 pandemic obliged physicians to find out alternative options to classical pathways, to lower viral spread and related dangers as well as to cope with redeployment of personnel and resources. We describe here two cases in whom surgery for adrenal Cushing’s syndrome (CS) and pheochromocytoma (PHEO) was deferred due to the unavailability of surgical facilities.Case no 1: A 69-yo woman was evaluated for CS. Type 2 diabetes mellitus was diagnosed...

Introduction: The long acting GLP-1 analogue, Semaglutide (S), is indicated for the treatment of adults with type 2 diabetes mellitus (T2DM). Since November 2021, S has also been approved by the European Medicines Agency (EMA) at a dose of 2.4 mg for the treatment of obesity. Here, we report the efficacy of S, either alone or in combination with other antidiabetic drugs, in patients with T2DM and obesity on glycated hemoglobin (HBA1C) and weight loss.Pat...

The effects of conventional somatostatin analog (SSA) regimens on glucose homeostasis seem to have minor clinical impact in acromegaly. Recently, we performed a trial showing that high dose octreotide LAR significantly reduces IGF1 in acromegalic patients uncontrolled with conventional SSA doses. In this post-hoc analysis, we evaluated the effects of high doses versus high frequency octreotide LAR on glucose homeostasis (HbA1c, FPG, HOMA-R) in patients with acromegaly e...

Objective: In acromegaly, 25–50% of patients remain uncontrolled with conventional somatostatin analogue (SA) therapy. Evidence suggests that response may be improved by increasing the dose or frequency of administration of SAs. This study evaluated the efficacy and safety of octreotide LAR administered at a high dose or high frequency in patients with acromegaly.Methods: This was a 24-week prospective, multicenter, randomized, open-label trial in p...