Endocrine Abstracts

Introduction: Gloucestershire Paediatric Diabetes Team has implemented several innovations including carbohydrate counting from diagnosis, annual review clinics and family events. We seek to improve our patient engagement and experience to improve health outcomes.Aim: Improve the clinic experience for patients, their families and staff, based on their input, thereby encouraging greater engagement and patient attendance as part of the RCPCH quality Improv...

Background: Patients with Cushing’s Syndrome (CS) suffer from a variety of neuropsychiatric and cognitive problems. Following remission, some, but not all of these symptoms resolve. Recent cross-sectional studies in patients with CS show persistent structural and functional brain abnormalities. However, longitudinal studies using magnetic resonance imaging, and a detailed neurocognitive assessment, performed before and after treatment, are not available.<p class="abs...

Background: Patients with acromegaly responding to injectable somatostatin receptor ligands (SRL) are often treated for decades without deterioration of biochemical response (except for routine fluctuations in IGF-I control), unless there are changing clinical circumstances such as persistent or recurrent tumor growth. Oral octreotide capsules (OOC) have been formulated as a potential therapy for acromegaly and the safety and efficacy was evaluated in the CHIASMA OPTIMAL pivot...

Background: Most patients responding to injectable somatostatin receptor ligands exhibit IGF-I variability around the upper limit of normal (ULN) during long-term follow up. These fluctuations are thought to result from assay variability, nutrition, comorbid conditions, concomitant medications and other unknown factors. The magnitude and factors affecting this variability arenot well understood in patients with acromegaly treated with injectable SRLs.Met...

Background: Distinguishing non-specific signs/symptoms of acromegaly from treatment-emergent adverse events (TEAEs) in patients treated with somatostatin receptor ligands has proven difficult given limited data from placebo-controlled studies. The CHIASMA OPTIMALstudy provides a novel data set to evaluate the incidence of adverse events (AEs) in patients randomized to oral octreotide capsules (OOC) or placebo.Methods: A multinational, randomized, placebo...

Background: Data on the impact of withdrawal from long-acting somatostatin receptor ligand (SRL) injections on disease activity in patients with acromegaly are limited. The CHIASMA OPTIMAL study assessed the efficacy and safety of oral octreotide capsules (OOC) in adult patients with acromegaly responding to SRL injections. The placebo arm of this study allowed for assessment of acromegaly activity in patients after withdrawal from SRL treatment.Methods:...

Objective: The phase 3 CHIASMA OPTIMAL study assessed efficacy and safety of oral octreotide capsules (OOC) in patients with acromegaly controlled on injectable somatostatin receptor ligands (SRLs). Sensitivity analyses were conducted for efficacy endpoints using two methods of imputation (i.e., the process of replacing clinical data with substitution values) to address missing data points due to some subjects reverting back to their prior injectable SRL treatment.<p class...

Background: Muscle weakness persists in patients with acromegaly (ACRO) even long-term after disease control. Mechanisms determining this sustained impairment are not known. We hypothesized that alteration of muscle architecture, due to intramuscular fatty infiltration, is associated with muscle dysfunction in these patients.Patients and Methods: Thirty-seven acromegalic patients [21 females and 16 males, mean (± s.d.)age, 53 ± 9 years...

Background: Injectable somatostatin receptor ligands (SRLs) are the most widely used therapy to control acromegaly. Oral octreotide capsules (OOC) have been formulated as a potential therapy for this disorder and the efficacy and safety was evaluated in the CHIASMA OPTIMAL prospective phase 3 study in patients with acromegaly who were controlled on injectable SRL treatment of varying doses (Samson et al. ENDO 2020).Methods: Patients with confirm...

Introduction: Diabetes mellitus is as a major contributor to disease severity and mortality in patients with Covid-19 infection, as the estimated increase in risk of death in hospitalised patients is 3.5-times (for T1DM) and 2.03-times (for T2DM).This retrospective analysis recruited 35 patients from three London hospitals who presented with diabetic emergencies i.e. diabetic ketoacidosis (DKA), Hyperglycaemic hyperosmolar state( HHS), presence of ketone...