ECE2020 Audio ePoster Presentations Pituitary and Neuroendocrinology (217 abstracts)
Efficacy of monotherapy versus combined GH receptor antagonist therapy in patients with somatostatin receptor analogues resistant acromegaly
Găloiu Simona Andreea 1,2 , Emma Margarit 2 , Maria Lavinia Popa 2 , Ionela Baciu 1,2 , Dan Niculescu 1,2 , Raluca Trifanescu 1,2 , Radian Serban 1,2 , Anda Dumitrașcu 3 , Andra Caragheorgheopol 4 & Catalina Poiana 1,2
1Carol Davila University of Medicine and Pharmacy, Endocrinology, Bucharest, Romania; 2C.I.Parhon National Institute of Endocrinology, Pituitary and neuroendocrine disorders, Bucharest, Romania; 3C.I.Parhon National Institute of Endocrinology, Radiology, București, Romania; 4C.I. Parhon National Institute of Endocrinology, Research laboratory, București, Romania
Background and Aims: GH receptor antagonist (Pegvisomant –PEG) has been shown to obtain IGF1 normalization in 60–90% of patients with acromegaly in clinical trials. The aim of the study is to evaluate real life response and side effects of PEG treatment in monotherapy versus combined with somatostatin analogues and/or cabergoline in patients with somatostatin analogues resistant acromegaly.
Methods: We included 40 patients (22F/18 M) consecutively evaluated between Jan2001-Dec2019. Baseline and at 6 months, and then yearly till 10 years serum IGF1, glucose, hepatic enzymes and tumor diameters were recorded.
Results: All patients were previously operated and 26 were irradiated. There were 9 patients treated with PEGmonotherapy (highest dose 136.11 ± 61.93 mg/week) and 31 patients received combination therapy (highest PEG dose 81.93 ± 42.30 mg/week). IGF1 levels were lowered after 6 months and 1year of treatment and then remained stable till 10 years of treatment with PEG (from 2.27 ± 0.18 × ULN to 1.86 ± 0.16 and 1.35 ± 0.13 xULN at baseline, 6 months and 1 year, respectively, P = 0.012 baseline versus 6 months and <0.001 baseline versus 1 year; 0.001 1 year vs 6 months). We obtained control of acromegaly in 20% of patients at 6 months, and in 42% and 58.3% after 1 and 3 years. There were no hepatic adverse reactions and tumor diameters nonsignificantly raised from 15.76 ± 2.18 mm at baseline to 20.36 ± 2.99 mm at 6 months, 18.43 ± 3.62 mm at 1 year and 24.96 ± 67 mm at 4 years (n = 6). In patients treated by monotherapy, glucose level were lower at 6 months versus baseline (88.61 ± 19.68 and 101.96 ± 16.49 mg/dl, respectively, P = 0.01). Patients treated by monotherapy were more frequently controlled (8/9; 88.88%) than patients treated with combination (12/31; 38.70%), P = 0.01.
Conclusion: After 3 years of treatment with pevisomant, more than 50% of patients with somatostatin analogues resistant acromegaly were controlled. Patients treated with monotherapy were more frequently controlled and had better glucose control.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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