Endocrine Abstracts

Background: Pegvisomant has demonstrated efficacy in attaining IGF1 normalisation in previously uncontrolled acromegalic patients. A home care programme improves treatment compliance.

Aims: Evaluation of home educational program and quality of life (Qol).

Methods: Multicentre observational study involving eight Flemish centres. Uncontrolled acromegalic out-patients were trained for daily subcutaneous pegvisomant injection at home by one 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, 18, 24, 30 and 36. Preliminary results include IGF1 at baseline, 3, 4.5, 6, 12 and 18 months. Qol was assessed by Patient-Assessed Acromegaly Symptom Questionnaire (PAQ15).

Results: Eighteen patients were included. Associated treatments were long-acting somatostatin analogues (n=15): five patients were treated with octreotide LAR 30 mg monthly, four patients with lanreotide 90 mg monthly and six patients with lanreotide 120 mg monthly. In all participants, IGF1 decreased (sometimes needing dose adjustment of pegvisomant from 10 mg OD to 30 mg OD) and Qol improved significantly over time (P<0.001), based on decreased complaints of headache (P=0.002), perspiration (P=0.001), joint pain (P=0.007), fatigue (P=0.023) and soft tissue swelling (P=0.001). These improvements were durable and no drop-outs were observed Table 1.

Conclusion: Working with a specialist nurse may help to improve Qol by attaining rapid IGF1 normalisation, due to enhancing patients’ compliance. PAQ15 score improved both on short and longer term.