Endocrine Abstracts (2011) 26 P298

Effects of short (6 months) and long (18 months) term treatment with GH-receptor antagonist pegvisomant (PEG) on rhythm disturbances in acromegaly

Renata Simona Auriemma1, Rosario Pivonello1, Maria Cristina De Martino1, Giuseppe Cudemo2, Mariano Galdiero1, Ludovica F S Grasso1, Chiara Simeoli1 & Annamaria Colao1

1Department of Molecular and Clinical Endocrinology and Oncology, University Federico II, Naples, Italy; 2Department of Clinical and Experimental Medicine, University Federico II, Naples, Italy.

Aim: To evaluate the effects of short and long-term treatment with PEG on rhythm disturbances in a cohort of acromegalic patients resistant to long-term high-dose therapy with SA.

Patients and methods: Thirteen patients (4 M, 9 F, aged 44±9.25 years) entered the study. All patients started PEG at initial dose of 10 mg daily, then increased of 5 mg every 6 weeks on the basis of IGF1 levels, until IGF1 normalisation or until the achievement of the maximum dose of 40 mg daily. A standard 24-h ECG registration was performed in all patients at study entry and after 6 and 18 months of PEG to evaluate: mean (HR), maximum (MHR) and minimum (mHR) heart rate, pauses number (P) and duration (PD), supraventricular episodes number (SE) and duration (SED), ectopic beats number (EB) and duration (EBD).

Results: Compared to study entry, a slight but not significant decrease in HR, MHR and mHR was observed after 6-month PEG. Moreover, compared to study entry a significant decrease in HR (P=0.03), MHR (P=0.05) and mHR (P=0.05) was found after 18-month PEG. At study entry, one patient showed 36 P with PD of 2200 ms, 6 SE with SED of 400 ms and 1 EB with EBD of 200 ms; after long-term PEG, no P, no SE and no EB were recorded. Another patient, the youngest man, at study entry showed no P and no SE; after 6-month PEG 21 SE with SED of 920 ms were recorded, whereas after 18-month PEG 4 P with PD of 200 ms and 2 SE with SED of 600 ms were recorded.

Conclusions: In acromegalic patients resistant to long-term high-dose SA therapy long-term treatment with PEG reduces HR, MHR and mHR so that to improve hyperkinetic syndrome.

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