ECE2020 Audio ePoster Presentations Pituitary and Neuroendocrinology (217 abstracts)
Biliary stone disease in acromegaly under somatostatinanalogues: A longterm safety study
Nunzia Prencipe 1 , Daniela Cuboni 1 , Chiara Bona 1 , Alessandro Maria Berton 1 , Mirko Parasiliti Caprino 1 , Luigi Fenoglio 2 , Valentina Gasco 1 , Ezio Ghigo 1 & Silvia Grottoli 1
1University of Turin, Medical Science Department, Turin, Italy; 2Santa Croce and Carle Hospital of Cuneo, Medicine Department, Cuneo, Italy
Introduction: Somatostatin analogues (SSA) are one of the main effective drug used in acromegaly. Sludge and/or cholelithiasis development represents oneof the more common side effect. The aim of the study was to analyze the frequency of biliary adverse events (BAE) and possible predictive factors, to propose a work-up strategy for their management.
Method: This is a single centre, longitudinalretrospective study; we enrolled 91 acromegaly patients during SSA for at least one year. We evaluated biochemical markers of acromegaly (GH, IGF-1 e IGF-1/ULN) at diagnosis, at BAE onset or at last follow up. We also collected type, dose andduration of SSA, glucose and metabolic profile at diagnosis and follow up. For the detection of sludge/gallstone disease, an ultrasound was performed yearly. In patients developing BAE we evaluated ursodeoxycholic acid (UDCA)effectiveness.
Results: We divided patients into 4 groups: no BAE(G–); positive history for BAE (G+), cholelithiasis (G+ch) and only sludge (G+sl). 61,5% of patients developed at least one BAE (58.9% cholelithiasis and 41.1% only sludge). No differences between lanreotide, octreotide and pasireotide were found. Only five patients underwent cholecystectomy for symptomatic cholelithiasis. None of metabolic markers proved to be associated with BAE. All GH, IGF-I and IGF-1/ULN proved to be lower in G+ch, compared to G+sl, (P = 0.001).Kaplan-Meier curve showed that 50% of subjects developed BAE within 5 years from the SSA start. In 71% of subjects with BAE,UDCA treatment was started; 60% had a complete resolutionwithout recurrence, while 40% did not benefit from therapy. The UDCA clinical efficacy was statistically greater in G+sl than in G+ch (regression in 88% of cases versus 30%; p = 0.0009). The regression of BAE occurred after 12 months of therapy. Analyzing the Kaplan-Meier curve of the UDCA efficacy, it can be observed that in 50% of the subjects the BAE resolved after 5 years of therapy.
Conclusion: biliary stone disease is a frequent SSA adverse event, although it is often symptomless. Ultrasound follow-up and early UDCA therapy, represent a valid strategy in their management.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more