Endocrine Abstracts

Introduction: In sporadic acromegaly, downregulation of AIP protein of the adenomas associates with invasive tumour features and reduced response to somatostatin analogue treatment. AIP is a regulator of Gαi signaling, but it is not known how the biological function of the Gαi pathway is controlled.Aim: To study somatic GNAS and AIP mutation status, AIP and Gαi-2 protein expressions, Ki67 proliferation indices, and clinical parameters in p...

Background: Bone turnover is increased in active acromegaly. Despite normalization of bone turnover after treatment, the risk for vertebral fractures remains increased. Gonadal status, but not bone mineral density (BMD) is correlated to vertebral fracture incidence. Trabecular and cortical bone are differentially affected by GH and IGF-1. The trabecular bone score (TBS) is related to bone microarchitecture and provides further information not captured by BMD measurement.<p...

Introduction: Although biochemical markers of acromegaly disease activity, including GH and IGF1, may fluctuate from day-to-day, biochemical treatment response in clinical trials is generally monitored using single-point analyses. Accordingly, longitudinal evaluations may assess patient status more accurately. In a phase 3 trial, oral octreotide capsules (OOC) demonstrated sustained composite endpoint GH and IGF1 response for ≤13 months in 151 patients with acromegaly pr...

Background: Patients with secondary adrenal insufficiency show increased risk of cardiovascular disease. Higher doses of glucocorticoid replacement are related to an unfavourable metabolic profile. In the absence of randomized controlled trials assessing the effect of hydrocortisone dose on haemodynamics and blood pressure regulation, we determined effects of a higher vs a lower glucocorticoid replacement dose on blood pressure, the renin-angiotensin-aldosterone system (RAAS) ...

Background: Twice-daily formulation of pasireotide, a pituitary-directed therapy, is approved for treatment of Cushing’s disease. Here we present data from a phase III study designed to evaluate the more convenient once-monthly long-acting release (LAR) formulation of pasireotide (approved for acromegaly) in patients with Cushing’s disease.Methods: Patients with persistent, recurrent, or de novo Cushing’s disease (not candidates for surger...

Introduction: Hyponatremia is the most common electrolyte abnormality in clinical practice and given its impact on mortality and morbidity a relevant medical condition. Nevertheless little is known about factors influencing long-term outcome.Methods: This is a prospective observational 12 months follow-up study of patients with profound hyponatremia (≤125 mmol/l) admitted to the medical emergency department of two tertiary care centers in Switzerla...

Background: Apelin and arginine-vasopressin (AVP) are antagonists in the regulation of body fluid and osmotic homeostasis. So far there exist no data about apelin levels in patients with polyuria-polydipsia syndrome (PPS).Methods: Plasma apelin and copeptin concentrations were measured in 15 patients with complete central diabetes insipidus (cDI), in seven patients with complete nephrogenic diabetes insipidus (nDI) and 19 patients with primary polydipsia...

In this observational, retrospective, multicenter study, we analyzed data from 300 patients with pituitary incidentaloma followed in two Italian Hospital Center. We observed a predominance of female patients (65%), with an a mean age at diagnosis of 49 years (higher in men than women, 57 vs 45 years old). The main reason to perform imaging were neurological symptoms not related to the presence of adenomas (56%). Most cases were microadenomas (56%), and macroadenomas were more ...

Introduction: Acromegaly is a rare disease (estimated prevalence 40–125 cases per million) resulting from GH/IGF1 hypersecretion, mostly by pituitary adenomas. SAS has a prevalence of up to 80% in acromegalic patients. The high frequency of acromegaly-related comorbidities and delayed diagnosis although effective treatments exist, make it necessary a screening of acromegaly in at risk populations.Aim: In a national multicenter study, to determine th...

Ketoconazole is a 50/50 racemic mixture of two enantiomers (2S,4R and 2R,4S) used off label in the US for the treatment of endogenous Cushing’s syndrome by virtue of adrenal cortisol synthesis inhibition.COR-003 (levoketoconazole) is the more potent single (2S,4R) enantiomer of ketoconazole (KTZ) to inhibit adrenal cortisol synthesis and is currently being investigated in a multinational Phase 3 study for the treatment of endogenous Cushing’s s...