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Endocrine Abstracts (2013) 32 N1 | DOI: 10.1530/endoabs.32.N1

ECE2013 Nurse Posters (1) (5 abstracts)

Pegvisomant home care program is likely to improve treatment compliance leading to rapid IGF1 control

Els Rutten 1 , Dashty Husein 1 , Pascale Abrams 2 , Linsey Winne 3 , Els Feyen 1 & Guy T’Sjoen 1


1Department of Endocrinology, University Hospital Ghent, Gent, Belgium; 2Sint Augustinus Hospital, Wilrijk, Belgium; 3AZ Damiaan Hospital, Oostende, Belgium.


Background: Pegvisomant has demonstrated efficacy in attaining IGF1 normalisation in previously uncontrolled acromegalic patients. Improper or less than prescibed use may lead to suboptimal control.

Aim: Evaluation of home educational program.

Methods: Multicenter Flemish study in seven non-controlled acromegalic outpatients. All patients were trained for daily s.c. pegvisomant injection at home by one single specialist nurse during 2 h. Enhanced motivation was provided through regular follow-up visits on day 2, 3, and 7 (60′, and twice 45′, respectively) and 15′ phone calls at month 1, 1.5, 3, 4.5, 6, 12, and 18. Preliminary results include IGF1 at baseline, 3 and 4.5 months.

Results: Seven acromegalic patients uncontrolled with octreotide LAR (n=4; 30 mg monthly) or lanreotide (n=3; 120 mg per 3 weeks or monthly) were included in this observational study.

Upon dose adjustment from 10 OD to 20 mg OD for patient 1 IGF1 at 4.5 months further decreased to 152. For patients 2 and 5 IGF1 further decreased without dose titration to 253, and 107 respectively. No adverse events were recorded, except for more frequent hypoglycemic episodes in 1 insulin-treated woman with type 2 diabetes.

Table 1
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Age (gender)61 (F)59 (F)43 (M)62 (F)64 (M)66 (M)62 (M)
Pegvisomant starting dose (mg)10 OD10 OD10 OD10 EOD10 OD10 OD10 OD
IGF1 baseline (ng/ml)3471032311289299877341
IGF1 3 months later (ng/ml)3263351579312428050
M, male; F, female; OD, once daily; EOD, every other day.

Conclusion: In all participants IGF1 decreased significantly (P=0.018) within a time period of 3 months. Working with a specialist nurse may prove a key to success in attaining rapid IGF1 normalisation, due to enhance patients’ compliance.

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