ECE2015 Eposter Presentations Pituitary: clinical (121 abstracts)
Impact of gsp mutations in somatotroph pituitary adenomas on growth hormone response to somatostatin analogues: a meta-analysis
Zoe A Efstathiadou 1 , Alexandra Bargiota 2 , Alexandra Chrisoulidou 3 , Georgios Kanakis 4 , Lamprini Papanastasiou 5 , Anastasia Theodoropoulou 6 , Stylianos K Tigas 7 , Dimitra Vassiliadi 8 , Maria Alevizaki 9 & Stylianos Tsagarakis 10
1Department of Endocrinology, ‘Hippokration’ General Hospital of Thessaloniki, Thessaloniki, Greece; 2Department of Endocrinology, University of Thessaly, Larissa, Greece; 3Department of Endocrinology-Endocrine Oncology, Theagenion Cancer Hospital, Thessaloniki, Greece; 4Endocrine Unit, Athens Naval and VA General Hospital, Athens, Greece; 5Department of Endocrinology and Diabetes Center, Athens General Hospital ‘G. Gennimatas’, Athens, Greece; 6Department of Internal Medicine, Division of Endocrinology, University Hospital of Patras, Rio, Greece; 7Department of Endocrinology, University of Ioannina, Ioannina, Greece; 8Endocrine Unit, Second Department of Internal Medicine, University of Athens, Medical School, ‘Attikon’ Hospital, Athens, Greece; 9Endocrine Unit, Department of Medical Therapeutics, Athens University School of Medicine, Athens, Greece; 10Department of Endocrinology, Evangelismos Hospital, Athens, Greece.
Objective: Somatic mutations in the GNAS1 gene, which encodes the alpha-subunit of G stimulatory proteins (gsp), are frequently detected in somatotroph pituitary tumors and have been associated to specific clinical-smaller and less invasive tumors occurring in older patients- and histopathological-densely granulated adenomas- characteristics. However, the question whether the presence of a somatic gsp mutation affects the response to somatostatin analogue treatment remains unresolved.
Design: Following a literature search, we performed a meta-analysis, including eight eligible studies, in order to estimate the effect of gsp mutation on the percent reduction of growth hormone (GH) levels during an acute octreotide suppression test (OST). A total of 310 patients with acromegaly (126 gsp (+) and 184 gsp (−)) were included in the analysis.
Results: The presence of the gsp mutation was related with a greater reduction in GH levels on OST (weighted mean difference (WMD): 9.08% (95% CI, 2.73, 15.42; P=0.005; random effects model). There was significant heterogeneity for this effect estimate (I2=58%, P value for heterogeneity=0.02). A sensitivity analysis after exclusion of a study with different methodology of OST provided similar estimates (WMD: 6.93% (95% CI, 1.40, 12.46); P=0.01) albeit with no significant heterogeneity (I2=35%, P value for heterogeneity=0.16).
Conclusions: The present meta-analysis suggests a role for gsp mutation as a predictive factor of which patients with acromegaly are best candidates for treatment with somatostatin analogs. In order to further clarify this position, studies evaluating the long term effect of treatment, using the combination of GH and IGF-1 measurements are needed.
Disclosure: The Greek School of Endocrinology Initiative was organized and funded by Ipsen. Statistical support and publication costs associated with this paper were also funded by Ipsen. The development at all stages of the concept and content of this pa
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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