ECE2015 Eposter Presentations Pituitary: clinical (121 abstracts)
Metformin-based oral antidiabetic therapy proved effective in hyperglycaemia associated with pasireotide in patients with acromegaly
Anna Maria Colao 1 , Feng Gu 2 , Monica R Gadelha 3 , Aart J van der Lely 4 , Maria Fleseriu 5 , Vanessa Passos 6 , Shoba Ravichandran 6 , Yin Miao Chen 6 & Marcello D Bronstein 7
1Dipartimento di Medicina Clinica e Chirurgia, Università Federico II di Napoli, Naples, Italy; 2Key Laboratory of Endocrinology, Department of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Beijing, China; 3Division of Endocrinology, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; 4Department of Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; 5Northwest Pituitary Center, Oregon Health and Science University, Portland, Oregon, USA; 6Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA; 7Neuroendocrine Unit, Division of Endocrinology and Metabolism, University of São Paulo Medical School, São Paulo, Brazil.
Introduction: High affinity binding of pasireotide for both sst2 and sst5 leads to its enhanced efficacy in treatment of acromegaly but results in decreased secretion of insulin, incretins (GLP-1 and GIP) and, to a lesser extent, glucagon. Metformin may be a good option in patients with acromegaly experiencing hyperglycaemia with pasireotide as it improves GLP-1 secretion. We analysed data from a 12-month, Phase III, randomised study in medically naïve patients with acromegaly to better understand the effects of antidiabetic agents used during pasireotide treatment.
Methods: Patients were randomised to pasireotide LAR 40 mg/28 days (n=176) or octreotide LAR 20 mg/28 days (n=182) for 12 months. Patients (n=57) randomised to pasireotide who were not receiving antidiabetic medication at baseline and who initiated such medication during the study were included in this analysis. Three groups were analysed: patients receiving i) metformin alone; ii) metformin+another oral antidiabetic (OAD); and iii) insulin±OAD.
Results: Metformin was the most commonly initiated antidiabetic; metformin alone (n=24), metformin+another oral antidiabetic (OAD; n=19) and insulin±OAD (n=10). Mean (S.D.) fasting plasma glucose (FPG) and HbA1c at baseline were 94.7 (13.0) mg/dl and 5.8% (0.4%) for metformin alone, 99.7 (12.8) mg/dl and 5.8% (0.4%) for metformin+another OAD, and 106.7 (19.7) mg/dl and 6.1% (0.5%) for insulin±OAD. Mean (S.D.) FPG values at month 3 were 131.0 (37.2), 153.2 (41.6) and 170.0 (88.6) mg/dl, and at month 12 were 126.7 (17.4), 132.6 (25.0) and 137.1 (31.7) mg/dl in the three groups. HbA1c values were 6.6% (0.5%), 7.0% (1.0%) and 8.7% (1.9%) at month 3, and 6.6% (0.7%), 6.7% (0.6%) and 7.2% (1.2%) at month 12.
Conclusions: At month 12, patients treated with metformin monotherapy or in combination with OAD agents had a mean HbA1c that met the ADA/EASD goal of <7%. Metformin-based OAD therapy proved effective in hyperglycaemia associated with pasireotide in patients with acromegaly.
Disclosure: This work was supported by Novartis.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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