Endocrine Abstracts

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...

Objectives: Kids in control of food (KICK-OFF) is a 5-day structured education programme for 11–16 year olds with type 1 diabetes who use multiple daily insulin injections. This study evaluates whether KICk-OFF would be considered a cost effective use of NHS resources by decision makers in the UK.Methods: A cost effectiveness analysis comparing KICk-OFF to usual care was conducted. Data from the KICk-OFF trial were extrapolated to simulate lifetime ...

Background: Currently there are no evaluated diabetes teaching packages for primary school age children which meet their learning needs, styles and are delivered by trained educators. Sheffield children’s Hospital produced and tested, as a randomized controlled trial (RCT), the KICk-OFF course for 11–16 year olds. This 5-day course based on carbohydrate counting and insulin dose adjustment showed significant improvement in HbA1c (9 mmol/mol, 0.8%) for those with poor...

Introduction: Trans-sphenoidal Surgery (TSS) remains the primary treatment for acromegaly in most patients, but no previous data exist on outcomes for patients treated with gamma knife radiosurgery (STRS) as a primary treatment.Methods: 20 patients with acromegaly underwent primary STRS at the National Centre for Radiosurgery, Sheffield, UK between 1985 and 2015. Data collection: note review, database, laboratory results, patient questionnaire, and death...

Context: Cushing’s disease (CD) results from the release of high levels of adrenocorticotrophic hormone (ACTH) from a pituitary adenoma. Increased ACTH secretion stimulates excess cortisol production, causing weight gain, hypertension, diabetes and depression. The only curative treatment is transsphenoidal surgery, but the rate of recurrence is high and there is a lack of suitable medical therapies. RNA-interference is a mechanism of post-transcriptional gene silencing th...

A 41-year-old woman was referred with 9 months history of secondary amenorrhoea and galactorrhoea. She was otherwise well and not taking any medications. Biochemical evaluation showed prolactin 2000 mU/l but otherwise unremarkable. Pituitary MRI revealed a 30 mm pituitary lesion with right cavernous sinus invasion, presumed to be a craniopharyngioma due to the presence of calcification. Surgical intervention was recommended, but the patient declined. She was commenced on caber...

Introduction: Current testosterone replacement therapies have limited acceptability: gels can be messy and risk inadvertent dosing of others; injections are painful; and oral testosterone undecanoate (TU) delivers variable testosterone levels, requires concurrent ingestion of a fatty meal and may produce supraphysiological dihydrotestosterone (DHT) levels1. We present the first human trial of an oral native testosterone preparation formulated to deliver testosterone...

The commonest cause of acquired hypopituitarism is a benign pituitary adenoma. However, in patients with non-pituitary malignancy different diagnoses need to be considered. We describe three oncology patients presenting with hypopituitarism and/or a pituitary mass where the cause was related either to malignant disease or its treatment.Case 1: A 56-year-old man with known metastatic melanoma presented with increasing lethargy. Investigation showed a larg...

Background: Cushing’s disease is associated with high morbidity and mortality, and there are currently no approved medical therapies. Twice-daily pasireotide sc showed efficacy in patients with mostly moderate-to-severe (UFC≥2×ULN) Cushing’s disease in a large, randomized, double-blind, 12-month trial. A monthly long-acting release (LAR) formulation of pasireotide has been developed to provide a smoother pharmacokinetic profile, potentially a better effica...

Background: SDH mutations cause about 80% of familial pheochromocytomas / paragangliomas (1). Although mutations in each subunit are associated with a particular clinical spectrum of disease, there is no clear genotype-phenotype correlation of a specific mutation, nor with penetrance of disease. We report characteristics of patients with SDH mutations seen in a single dedicated tertiary referral clinic.Methods: A retrospective observational study of pati...