ECE2013 Nurse Posters (1) (5 abstracts)
1Department of Endocrinology, University Hospital Ghent, Gent, Belgium; 2Sint Augustinus Hospital, Wilrijk, Belgium; 3AZ Damiaan Hospital, Oostende, Belgium.
Background: Pegvisomant has demonstrated efficacy in attaining IGF1 normalisation in previously uncontrolled acromegalic patients. Improper or less than prescibed use may lead to suboptimal control.
Aim: Evaluation of home educational program.
Methods: Multicenter Flemish study in seven non-controlled acromegalic outpatients. All patients were trained for daily s.c. pegvisomant injection at home by one single specialist nurse during 2 h. Enhanced motivation was provided through regular follow-up visits on day 2, 3, and 7 (60′, and twice 45′, respectively) and 15′ phone calls at month 1, 1.5, 3, 4.5, 6, 12, and 18. Preliminary results include IGF1 at baseline, 3 and 4.5 months.
Results: Seven acromegalic patients uncontrolled with octreotide LAR (n=4; 30 mg monthly) or lanreotide (n=3; 120 mg per 3 weeks or monthly) were included in this observational study.
Upon dose adjustment from 10 OD to 20 mg OD for patient 1 IGF1 at 4.5 months further decreased to 152. For patients 2 and 5 IGF1 further decreased without dose titration to 253, and 107 respectively. No adverse events were recorded, except for more frequent hypoglycemic episodes in 1 insulin-treated woman with type 2 diabetes.
1 | 2 | 3 | 4 | 5 | 6 | 7 | |
Age (gender) | 61 (F) | 59 (F) | 43 (M) | 62 (F) | 64 (M) | 66 (M) | 62 (M) |
Pegvisomant starting dose (mg) | 10 OD | 10 OD | 10 OD | 10 EOD | 10 OD | 10 OD | 10 OD |
IGF1 baseline (ng/ml) | 347 | 1032 | 311 | 289 | 299 | 877 | 341 |
IGF1 3 months later (ng/ml) | 326 | 335 | 157 | 93 | 124 | 280 | 50 |
M, male; F, female; OD, once daily; EOD, every other day. |
Conclusion: In all participants IGF1 decreased significantly (P=0.018) within a time period of 3 months. Working with a specialist nurse may prove a key to success in attaining rapid IGF1 normalisation, due to enhance patients compliance.