ECE2013 Poster Presentations Pituitary – Clinical (<emphasis role="italic">Generously supported by IPSEN</emphasis>) (127 abstracts)
Efficacy and safety of lanreotide in combination with pegvisomant in clinical practice in patients with active acromegaly with monotherapy failure
Eva Venegas 1 , Tomás Lucas 2 , Mónica Marazuela 3 , Guillem Cuatrecasas 4 , Maria Angeles Galvez 5 , Enrique Romero 6 , Francisco Morales 7 , Susan M Webb 8 , Betina Biaggeti 9 , Juan José Diaz 10 , José Antonio Mato 11 , Ricardo Vilchez 12 , Ignacio Bernabeu 13 , Miguel Paja 14 , Antonio Picó 15 , Manuel Puig Domingo 16 , Alfonso Soto 1 & on behalf of ACROCOMB study group 17
1Hospital Universitario Virgen del Rocío, Sevilla, Spain, 2Hospital Universitario Puerta de Hierro, Majadahonda, Spain; 3Hospital Universitario La Princesa, Madrid, Spain; 4Clínica Teknon, Barcelona, Spain; 5Hospital Universitario Reina Sofía, Córdoba, Spain; 6Hospital Clínico Universitario, Valladolid, Spain; 7Hospital Universitario Infanta Cristina, Badajoz, Spain; 8Hospital e IIB Sant Pau, CIBERER 747, Barcelona, Spain; 9Hospital Universitario. Vall d’Hebron, Barcelona, Spain; 10Hospital Universitario Ramón y Cajal, Madrid, Spain; 11Complexo Hospitalario de Ourense, Ourense, Spain; 12Hospital Universitario Virgen de las Nieves, Granada, Spain; 13Hospital Clínico Universitario, Santiago de Compostela, Spain; 14Hospital Clínico Universitario, Bilbao, Spain; 15Hospital General Universitario de Alicante, Alicante, Spain; 16Hospital. Universitario Germans Trias i Pujol, Badalona, Spain; 17Hospital Universitario Virgen del Rocío, Sevilla, Spain; 18ACROCOMB Study, Spain, Spain.
Introduction: ACROCOMB is a retrospective Spanish Multicenter study, designed to evaluate the efficacy (extent of tumour control) and safety of lanreotide (LAN) treatment combined with pegvisomant (PEG) or cabergoline in acromegalic patients with monotherapy failure.
Methods: patients with acromegaly treated with LAN+PEG (45% of ACROCOMB patients) at 44 Spanish Endocrinology Departments were analysed.
Results: 40% of patients were male, median age: 42.5 years. Mean time from diagnosis was 7.2±7.5 years. Tumour size at diagnosis was 25.5±9.9 mm. 92% of patients had surgery and 65% had radiotherapy. Immediately prior to LAN+PEG, 57% were receiving LAN, 4% octreotide, 35% PEG, 2% cabergoline and one patient was not receiving treatment. Median baseline IGF1 was 156% ULN (15–534%). LAN+PEG was indicated for monotherapy failure (85%), tumoural volume control (12%), headache (8%). 14% of patients received LAN+PEG for >1 reason. Median LAN+PEG treatment duration was 2.1 years (0.4–6.3). Median monthly LAN doses were similar at baseline (120 mg (60–240)) and at end of study (EOS) (120 mg (30–240)). At baseline 21% of patients were receiving an extended LAN regimen (q6w or q8w) and at EOS 25%. Median weekly PEG doses increased from 70 mg (10–210) at baseline to 105 mg (30–210) at EOS. Median IGF1 values decreased by 6 months (83% ULN (11–236%), P<0.0001) and remained stable at EOS (84% ULN (23–345%), P<0.0001). At EOS 71% of patients had normal IGF1 values; drug infradosing might explain lack of normalization in the other patients. Tumour size decreased in 3 patients. No changes in hepatic, cardiac, glycemic parameters were reported. 41 (79%) patients continue receiving LAN+PEG at EOS.
Conclusion: The combination of LAN and PEG is well-tolerated and has high efficacy in clinical practice in patients not well controlled with monotherapy. No significant liver enzyme elevations were observed.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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