ECE2018 Poster Presentations: Pituitary and Neuroendocrinology Pituitary - Clinical (101 abstracts)
Trends of insulin-like growth factor 1, growth hormone, and biochemical control of patients with acromegaly in italy: a longitudinal retrospective chart review study
Annamaria Colao 1 , Ludovica Grasso 1 , Marialuisa Di Cera 1 , Wendy Y Cheng 2 , Philippe Thompson-Leduc 2 , Hoi Ching Cheung 2 , Mei Sheng Duh 2 , Maureen P Neary 3 , Alberto M Pedroncelli 4 , Ricardo Maamari 3 & Rosario Pivonello 1
1University Federico II, Naples, Italy; 2Analysis Group, Inc., Boston, USA; 3Novartis Pharmaceuticals, East Hanover, USA; 4Novartis Pharma AG, Basel, Switzerland.
Long-term biochemical control (i.e., normalization of growth hormone [GH] and insulin-like growth factor-1 [IGF1]) is the goal of treatment of acromegaly. Few studies have characterized the sustainability of GH/IGF1 levels in acromegaly patients. This study aimed to identify long-term time trends of GH, IGF1 levels, and biochemical control in patients with acromegaly using longitudinal real world data. Medical records of adult patients with a confirmed acromegaly diagnosis, ≥2 readings of GH and IGF1, and ≥6 months of follow-up at an endocrinology center in Italy, were reviewed. Patients were followed from first documented GH and/or IGF1 measurement at the study center until end of data availability, loss to follow-up, or death. Mean GH and IGF1 levels were obtained across multiple measurements per year. Biochemical control was assessed annually and defined as having >50% of IGF1 measurements ≤upper limit of normal, or GH measurements ≤2.5 μg/L (when IGF1 unavailable). Latent class growth analyses were conducted to identify different time trends of mean IGF1, mean GH, and probability of being biochemically controlled over 10 years, and to estimate the proportion of patients presenting with these time trends. Trend assignments were based on model fit. All 150 eligible patients were Caucasian, 47% female, with mean age of 43.1 years (range: 19–70) at diagnosis and a mean follow-up time of 9 years. 81 (54%), 84 (57%), and 81 (54%) patients had normal IGF1, GH, and biochemical control status, respectively, for ≥50% of the follow-up period. Four trends were identified for IGF1 (% of population; mean levels): one stable (15.3%; 186.5 ng/mL) and three declining ([1] 39.3%; initial [year 1]: 465.8, last [year 10]: 142.9; [2] 38.0%; initial: 576.8, last: 280.1; [3] 7.3% initial: 664.1, last: 403.4). Three declining trends were identified for GH ([1] 23.6%; initial: 1.63 μg/L, last: 0.32 μg/L; [2] 50.7%; initial: 4.57, last: 1.03; [3] 25.7% initial: 12.99, last: 3.34). Probability of achieving biochemical control followed two trends (% of the population; probability of control): one stable (26.7%; 20.4%) and one increasing (73.3%; initial: 33.1%, last: 98.0%). Results show that IGF1 and GH levels were initially elevated in the majority of patients, and declined over time. Biochemical control was reached by ≥70% of patients after 10 years. One-third of the population had low likelihood of achieving control at any time. Future research is warranted to understand the impact of long-term biochemical levels on patients’ disease course.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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