Endocrine Abstracts

Introduction: Acromegaly – a serious debilitating disease resulting in decreased quality and length of life. Due to the late nature of the diagnosis, the lack of prospects for a surgical or non-radical adenomectomy leads to a somatostatin analogues (SA) treatment as primary or secondary therapy, which is a long-term, sometimes lifelong. Therefore, the question of tolerability and prevention of life-threatening complications for these patients is very important. Since the development of gallstones is an expected side effect of long-term use of SA, the authors decided to test the effectiveness of ursodeoxycholic acid (UA) to prevent and cure gallstone patients receiving SA.

Description of methods/design: In a 3-year observation was attended by 44 patients (11 men and 33 women) with acromegaly treated with SA and concomitant chronic cholecystitis. Thirteen patients at baseline revealed gallbladder stones and 31 biliary sludge. Twenty-eight patients received the UA (group 1) and the remaining 16 for various reasons did not receive drug therapy (group 2). Groups did not differ by sex, age (54.2±11.4 and 58.8±10.6), level of IGF-1 (703.8±369.9 and 676.9±300.8 ng/ml) and GH (3.1±4.4 and 6.1±11.7 ng/ml) and prevalence of cholelithiasis and biliary sludge. Initial dose was 500 mg UA at night and adjusted every 6 months.

Results: In group 1, none of the patients developed acute cholecystitis, 31% of patients in group 2 developed acute cholecystitis. A negative correlation between UA treatment and acute cholecystitis development in the total group was shown (r=−0.45, P<0.05). And also noted a negative correlation between the success of therapy and duration of the active phase of acromegaly in patients history (r=−0.89, P<0.05).

Conclusion: i) Permanent treatment with UA effectively prevent cholecystitis progression in acromegaly patients with SA treatment. ii) Prevention of surgical treatment increase quality of life.