Effect of short- and long-term treatment with pasireotide on hemochrome in patients with Cushing

Alessia Cozzolino; Chiara Simeoli; Laura Trementino; Leo Monica De; Pasquale Vitale; Davide Iacuaniello; Aurora Albano; Marco Boscaro; Annamaria Colao; Giorgio Arnaldi; Rosario Pivonello

doi:10.1530/endoabs.32.P917

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Endocrine Abstracts (2013) 32 P917 | DOI: 10.1530/endoabs.32.P917

ECE2013 Poster Presentations Pituitary – Clinical (<emphasis role="italic">Generously supported by IPSEN</emphasis>) (127 abstracts)

Effect of short- and long-term treatment with pasireotide on hemochrome in patients with Cushing's disease

Alessia Cozzolino ¹ , Chiara Simeoli ¹ , Laura Trementino ² , Monica De Leo ¹ , Pasquale Vitale ¹ , Davide Iacuaniello ¹ , Aurora Albano ¹ , Marco Boscaro ² , Annamaria Colao ¹ , Giorgio Arnaldi ² & Rosario Pivonello ¹

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¹Section of Endoicrinology, Department of Clinical Medicine and Surgery, Federico II Uiversity, Naples, Italy; ²Division of Endocrinology, Polytechnic University of Marche, Ancona, Italy.

Introduction: Glucocorticoids (GC) have a stimulatory effect on neutrophils and an inhibitory effect on the other leukocyte subpopulations. A potential stimulatory effect on erythropoiesis has been also hypothesized. The aim of our study was to evaluate the effect of pasireotide treatment on hemochrome parameters in patients with endogenous pituitary-dependent glucocorticoid excess or Cushing’s disease (CD).

Patients and methods: Fifteen patients with CD (19–57 years, 14 F, 1 M) and 45 sex-, age- and BMI-matched healthy controls entered the study. Hemochrome evaluation has been assessed at baseline and after 3 and 6 months of pasireotide treatment (dose 1200–2400 μg/day).

Results: Significantly higher levels of hematocrit (HCT) (P=0.019) and neutrophils (P=0.002) and a significantly lower number of lymphocytes (P=0.000) and eosinophils (P=0.009) have been observed in patients than controls. After 3 months of treatment, 8/15 patients (53.3%) normalized urinary free cortisol (UFC) levels and the percentage of reduction in UFC levels ranged from 25 to 96%; a significant decrease in platelets (PLT) (P=0.002) and neutrophils (P=0.017) and also a significant increase in lymphocytes (P=0.03), eosinophils (P=0.035) and basophils (P=0.011) have been observed. After 6 months, 5/13 patients (38.5%) had a persistent UFC normalization and the percentage of reduction in UFC levels ranged from 30 to 91%; so as after 3 months, a significant decrease in PLT (P=0.015) and neutrophils (P=0.023) and a significant increase in lymphocytes (P=0.002) and basophils (P=0.034) have been observed. No significant correlation was found between UFC levels and the different parameters of hemochrome at baseline and no significant correlation was found between their changes after 3 and 6 months of treatment.

Conclusions: Medical therapy with pasireotide is able to improve hemochrome parameters commonly altered in CD. These findings are probably due to a significant decrease in cortisol secretion, although a contributing or determinant role of different factors cannot be ruled out.